NAME :
ADDRESS :
CITY :
STREET :
STATE :
ZIP CODE :
COUNTY :
EMAIL (VERY IMPORTANT) :
CREDIT CARD NUMBER
EXPIRY DATE :
ADDITIONAL INFORMATION:
If you don't want to put your credit card information here, you can print this out and fax us to (662) 2544649
155/14-15 soi chaiyot ( soi 11/1) sukhumvit road
near swiss park hotel behind siam commercial bank
Bangkok 10110. Thailand
Tel : (662) 2554648, 6510340 Fax : (662) 2554649
E-mail :
sales@presidenttailors.com