Credit Card Form - Air Ticketing

This is to authorise :

AT NETWORK CO., LTD. THAILAND

To debit Baht...............................................................................

For routing : ................................................................................

Booking under the name of : ......................................................

Period of booking : .....................................................................

Against Credit Card Type : ..........................................................(VISA, MASTER, JCB, AMEX CARD)

Credit Card No : ..........................................................................

Batch Code (4 digit no. for AMEX only) : ....................................

Cardholder Name : .....................................................................

Expiry date : ...............................................................................

Signature of Cardholder : ...........................................................

Date : ..........................................................................................

*********************IMPORTANT*********************

Please kindly print this form, fill-in your Credit Card details and
fax it to our Bangkok Office at Fax: (66-2) 677-6246 to 7
PLEASE ATTENTION TO PAM.