| Name of Buyer: |
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| Address Line 1: |
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| Address Line 2: |
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Country: |
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Tel Number: |
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Fax Number: |
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Detail of product purchased-tailored clothes.
I authorize Henry Fashion to charge my credit card.
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Credit Card: |
VISA
MASTER CARD
SCB
AMEX
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Card
Number: |
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The last three-digit number appearing on the signature panel.
(VISA/Master) |
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For
The four-digit number appearing on the right corner of the card (
AMEX) |
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Cardholder Name: |
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Expiry Date: |
Month:
Year:
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Amount(Thai Baht) - THB: |
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Cardholder Signature: |
____________________________________________ |
Return-refund Policy=No Refund
Delivery Process=Airmail.
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Approval Code
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