****************************************
                  * ASIA TRAVEL CREDIT CARD PAYMENT FORM *
                  ****************************************
 

ATTENTION: ____________________________   FAX NOS:(632)6356699;7476447
           (pls. state name of contact 
         person for hotel/resort at hand)

               

This is to authorize AT PHILS. to debit the total amount of 

**  ___________________________________________________________________
                             (amount in words)

US$ DOLLARS/Php PESOS** ONLY (US$___________ net)/(Php ___________ net)
 (pls. encircle one)

against my credit card as payment for this reservation request.

Please fill-in the blanks for documentation purposes
(data are to appear in the booking order):

Name/s of Room Occupant/s: ____________________________________________

# of Room/s & Room Type/s: ____________________________________________

Special Requests: _____________________________________________________
                           (subject to availability)

Arrival Flight No: ____________  Arrival Flight Time: _______________

# of Adult/s & Child/ren (below 12 y.o.) to Occupy Room: ____________  

COMPUTATION FOR ACCOMMODATION at _________________________________:

Length of Stay: _________________ to _________________ (______ night/s)

Promotional Rate: US$ ________________.00 net x _______ night/s 

                  x _______ room/s = US$_______________.00 net 

Total Amount to be Debited from Card: 

                  US$________________.00 net/Php _______________.00 net

Exchange Rate Used: US$1.00 = Php _______.____ (As of, ___/___/___)

CREDIT CARD DETAILS:

a. Encircle Credit Card Type:   VISA   MASTERCARD  Cards Only 

b. Name Printed on Card:  _____________________________________________

c. Credit Card Number: ________________________________________________

d. Expiry Date: _______________________________________________________

e. Billing Address: ___________________________________________________

f. Tel. #/s: pls. specify country code & area code  ___________________

g. E-mail Address/es: (1) ___________________ (2) _____________________



___________________________               _____________________________
  SIGNATURE OF CARDHOLDER		             DATE

** Option date to fax ASIA TRAVEL CREDIT CARD PAYMENT FORM or SUPPLY 
CARD DETAILS: AT LEAST 3 DAYS PRIOR TO CHECK-IN DATE.
** For booking above to be activated, guest is required to e-mail 
the contact person of hotel at hand notifying that this ASIA TRAVEL 
CREDIT CARD PAYMENT FORM had been completely filled-out & faxed to 
(632) 6356699 or (632) 7476447 - kindly indicate fax no. used. 
** In the event that guest failed to inform Asia Travel of the 
successful faxing of this form to our office, Asia Travel will NOT 
be held liable for the probable non-booking of this reservation 
request. 
** A 5.5% credit card processing charge will be extended to credit card
if cancellation is tendered 1 DAY AFTER BOOKING HAS BEEN CONFIRMED. 
** Should you have further queries, please feel free to get in touch 
with us at: Unit 1203-1204, 12/F Prestige Tower, Emerald Avenue, 
Ortigas Center, Pasig City, Philippines 
TEL. NOS: (632) 6344220/40/60, 6343909-10/19 
FAX NOS: (632) 6356699; 7476447 
Office Hours: Mon.-Fri. 9AM-12NN; 1PM-6PM; Sat. 10AM-12NN; 1PM-3PM