Blue Ocean Resort, Patong Beach,Phuket, Thailand - Credit Card Authorization Form

Credit Card Authorization Form – Please Print Out

To reserve your room please complete the below Credit Card Authorization Form and fax it
back to our address below. Please note that a certain deposit is required to hold your booking.

Important: Please ensure that you receive confirmation by E-mail on
your booking request prior to sending this Credit Card Authorization.

To: Blue Ocean Resort FAX NUMBER: +66-76-345194, +66-76-340193

From	___________________________________
Address	___________________________________
Tel	______________ Fax _________________
Email	___________________________________
Credit Card Details:
Date	___________________________________
I, ____________________________ (Name) authorise Blue Ocean Resort to charge(amount)_____________ to my ( )Visa, ( )Master Card (please tick one)
Cardholder’s Name	___________________________________
Card Number	___________________________________
Expiry Date	___________________________________
Signature as on Card	___________________________________

Please include the complete number set of your credit card
( for Visa and Master card the last 3 digits, American Express the first 4 digits )