CREDIT CARD FORM
Your Credit Card is Safe with homestayinthailand.com

Homestay Paradise (Thailand) Co., Ltd.

Please debit (Amount) ............................................................................................................................... Baht

Against Credit Card : ..................................................................................................................................
[ VISA, MASTER, AMEX, DINERS CLUB or JCB]

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

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

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

E-mail : .......................................................................................................................................................

Please advise the last three-digit number or four digit number (for AMEX)
appearing on signature panel (if any) : .................................................... ( See example )

For payment of : .........................................................................................................................................

Hotel name : ................................................................................................................................................

Guest name : ................................................................................................................................................

E-mail address : ............................................................................................................................................

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

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

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

Please print this form, fill-in your details and fax it back to our Office at (665)521-5440 Attn. K.Netra   E-mail : sales@homestayinthailand.com

We make your online reservation extremely satisfying, comfortable and without apprehension over your security and privacy.