Budget and probably others will rent you a car with a US/UK license. Probably others also if in English. I used a UK license for 8 years until I got a Thai license. With a Thai license, they don't even need a passport. The new Thai licenses have Thai and English writing including your passport number.
Although they accept the UK/US license alone, it is likely that their insurance company may not accept not having a Thai/International license in the case of a major claim.
Obtaining a Thai license is remarkably easy now. If you have a foreign license..US/UK at least, they do not require an International license for the application. You can process the whole thing in about 90 minutes at Chatuchat and walk out with the license. They will require a medical certificate and an address certificate which is obtainable from Immigration free.
With a pickup and CarryBoy cover over the back, you can have all the sex you need in the back and save on the short-time hotel. Do it on the banks of the river along the back roads to the Mesa Elephant camp...so many pleasures open up with a vehicle at around Bht1,000/day.
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