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: +66-76-341142, +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 )






© 2003 Blue Ocean Resort; all rights reserved.
210/23 Soi Kepsap, 200 Pee Ratuthit Rd., Patong Beach, Phuket 83150, Thailand
Tel.: (+66 76) 345 191 - 193 | Fax: (+66 76) 340 193
E-mail:booking@phuket-blueoceanresort.com