Authorization of Charge
Please fill in the information, check the applicable boxes, sign it and fax it back to us at (66 2) 237-9322
Card Type: .........................................................................
Card Holders Name: ..................................................................
Card Number: .....................................................................
Cvv Number: ................
Expiration Date: ............ / ............
Amount Authorized in Thai baht: ................................ Baht

In Payment Of: One night reservation deposit  
    for No of adults..........................
for No of children.......................
 
Room Information
  Room Type
Mar 1, 2008- Oct 31, 2008
Nov 1, 2008 - Feb 28, 2009
Single Room w/shower (small bed for 1 pax)
1,400 Baht x 7% vat
1,400 Baht x 7% vat
Twin/Double Room w/shower(big bed for 1or2 pax)
2,000 Baht x 7% vat
2,200 Baht x 7% vat
Suite with sitting room
2,900 Baht x 7% vat
3,200 Baht x 7% vat
Studio Suite w/garden balcony
3,200 Baht x 7% vat
3,700 Baht x 7% vat
       

* These rates are inclusive of 10 % Service charge and American Breakfast already.

 

Extra Bed (Excluding breakfast)
600 Baht + 7%VAT
Check In date.................................... Check Out date.......................................  
Total number of nights...................................  
 
Total Room Price
.....................Baht 


Pickup Service Information(optional)
 
Single Trip :Car pick up at airport [1-4 pax]
1,100 Baht 
Single Trip :Car pick up at airport [5-7 pax]
1,600 Baht 
Single Trip :Limousine [Toyota Lexus][2-3 pax]
2,500 Baht 
Flight#.................. Arrival date..............Time..............


 
Total Pickup Service Price
.....................Baht 
     
 
Total Price
.....................Baht


I here with authorize, La Residence Hotel , Bangkok Thailand to charge the above stated amount on my credit card.

Authorized Signature......................................................................................

First Name...............................................Last Name.......................................

Date...............Month.............Year.............