Royal Tailor Phuket : Ladies & Gents Custom Tailor.

Authorization Form
I would like to proceed with my order of clothes from
ROYAL TAILORS

FULL NAME :

PASSPORT NO :

STREET :

CITY :

COUNTRY :

PROVINCE/STATE :

POSTAL CODE :

TEL :

FAX :

E-MAIL :

I authorize ROYAL TAILORS to

Deduct the sum of:

US$

From my Credit Card :

Card Number :

3 or 4 Digit Code:

Click for help

Diner 2 Letters:

Expiry Date :

(MM/YY)

.................................................................(Orders once placed cannot be cancelled)
Signature as on credit card Date

Please deliver my clothes to ( Leave blank if address same above )

FULL NAME :
STREET :
CITY :
COUNTRY :
PROVINCE/STATE :
POSTAL CODE :
TEL :

After Printing, Sign & Fax us this form

Royal Tailors Fax: +(66) 7628 6087

Royal Tailor Phuket
26,28 Luang Pho Chuan Rd, Karon Beach, Phuket 83100 Thailand
Tel: +66 7628 6236 Fax: +66 7628 6087 Mobile: +6685 88 999 58
E-mail: royalt@phuket.ksc.co.th