Authorization Form
I would like to proceed with my order of clothes from
Ambassador & Smart Fashion
FULL NAME :
PASSPORT NO :
STREET :
CITY :
COUNTRY :
PROVINCE/STATE :
POSTAL CODE :
TEL :
FAX :
E-MAIL :

I authorize Ambassador & Smart Fashion to
Deduct the sum of: US$ / Euro/GBP/AUD
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


Ambassador & Smart Fashion FAX: +66 2 255 4518