ASIA TRAVEL CREDIT CARD PAYMENT FORM
Please print out
this form, complete, sign and fax it to our Hong Kong Office (private fax) at
(852) 2405-0922 in order to pay for your reservation.
To: AT Reservation Network Pte Ltd or its nominee
(note
merchant name will appear as "www.asiatravel.com" on your credit card
statement)
This is to authorise you to debit the following amount from my
credit card :
Ref Number (as indicated on our email header,
if applicable) : ____________________________
Hotel / Tour Name :
___________________________________________
Amount to be
debited : US$ __________________
(for amount exceeding HK$3,000, you are requested to fax both sides
of your credit card - remember to print lightly so fax is clear)
a. Credit Card Type
: _________________________ (Visa, MasterCard or Amex )
b. Name Printed on Card : __________________________________________________
(note the card holder must be one of the guests ie no third-party payment
is allowed)
c. Credit Card Number : _________________________________________
d. Expiry Date : ____________________ (Month/Year)
Cancellation Policy :
____________________________________________
Signature of Card
Holder (important to sign as card signature)
For above booking
to be activated, guest is required to e-mail janet@asiatravel.com notifying that this
form had been successfully completed, signed and faxed to the above numbers.
Asia Travel Hong Kong Office
Tel : (852)
2736-0922
Fax : (852) 2405-0922
Working Hours :
Monday to Friday - 9:30 am to 6 pm
Saturday - 9:30 am to 1 pm