Fax Booking Form
APPLY FOR VISA / MASTER CARD /
AMERCAN EXPRESS / JCB CARD
........I hereby authorize the below
amount to be paid to
CHAWLA
TRAVEL CO., LTD. PART.
CARD HOLDER'S NAME:
..............................................................
| MY
CREDIT CARD: |
(..)
VISA |
(..) MASTER CARD |
| |
(..) AMERICAN EXPRESS |
(..) JCB CARD |
CREDIT CARD NUMBER
CREDIT CARD EXPIRY DATE :
..................................................................
**
FOR CREDIT CARD: 4 FIGURES ON CARD :
..........................................
AMOUNT TO BE PAID:
...................................................................
...................................................................................................................
SIGNATURE
DATE....../........./.......
Please print this form and send it to our Fax No. (+66-2)
237-0991.
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