CREDIT CARD PAYMENT FORM

RIMPING HOLIDAY TOURS CO.,LTD.
Tel./Fax 66 053 490-980 Mobile 081-2877019
E-mail : darunee_rimpingtr@yahoo.com

PERSONAL DETAILS please complete your personal details in full

NAMES Mr/Mrs/Ms.:____________________________________________________________________________________
SURNAME :_______________________________________FIRST NAME:________________________________________
NATIONALITY:____________________________________PASSPORT NO.______________________________________
PLACE& DATE OF ISSUE:_______________________________________ EXPIRY DATE:__________________________
DATE OF BIRTH:____________________________________ OCCUPATIONS____________________________________
ADDRESS DETAILS:
ADDRESS:_____________________________________________________________________________________________
HOME TELPHONE NO:_________________________________ FAX:____________________________________________
E-MAIL:_______________________________________NUMBER OF PERSONS:__________________________________
TOURS RATES PER PERSON:___________________________________________________________________________
TOTALLY::_____________________________________________________________________________________________
TOURS SERVICE ARRANGEMNENT PERIOD ON_________________________________________________________
PLEASE CHARGE ON MY CREDIT CARDS: [ ] VISA [ ] Master Card [ ] American Express
CARD MEMBER'S NAME:_______________________________________________________________________________
CARD NUMBER : |__|__|__|__| |__|__|__|__| |__|__|__|__| |__|__|__|__|
EXPIRATION DATE: ________________________________________________________
CARD HOLDER'S NAME:___________________________________________________
CARD HOLDER'S SIGNATURE: _____________________________________________
REMARKS:1 ALL TOURS ARE PROVIDED BY PRIVATE TOURS BASIS WITH ENGLISH SPEAKING GUIDE, OTHER
                     LANGUAGES ADVANCE BOOKING IS REQUIED.
                  2.FOR EVERY 15 PAYING PAX ONE PAX WILL BE GRANTED COMPLIMENTARY ON TRANSERS AND
                    TOURS WITH MEALS AS IN DICATED IN THE PROGRAM.
                  3.CHILDREN UNDER 10 YEARS OF AGE WILL BE CHARGED 50% OF THE ABOVE MENTIONED PRICES