I hereby authorized AMBASSADOR CITY JOMTIEN ,PATTAYA   to charge the

amount of THAI BAHT                                                                                               .

from                                                        to:                                                            

Cardholder's Name :                                                                        (as it appears on card)

Guest's Name :                                                                              (if different from above)

Card Number :                                                                                               

Master Card : write down the last 3 digits show on the back of the card :                              

AMEX : please inform Billing address                                                                                  

Expiry date :                                          Card company :                                             

Country:                                                         

SIGNATURE :                                                    Date :                                                   

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

Please kindly print this form, fill-in your details and fax it back to our Bangkok Office at
(66 ) 038 255-978 mail : rsvn@ambassadorcityjomtien.com
Remarks : The charge will be exercised only in case of No-Show or cancellation less then 48 hours before arrival. If guests come to stay in the hotel, this charge will be cancelled and guests have to pay in full amount at the hotel.