Order Form

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Order Form




Email *


You will receive a confirmation email from us after sending the form. If u do not get the reply, u ve entered a wrong email email address

Phone Number *




###

-



###

-



####

Name *



Shipping Address (full address) *




Street Address



Address Line 2



City



State / Province / Region



Postal / Zip Code



Country

Payment Method

 Bank Simpanan
Nasional 

 Maybank 
Cash Deposit

Item Code



Delivered By:




MM

/



DD

/



YYYY



HH

:



MM



AM/PM

I agree with all the terms and conditions

 Yes 
 No 
with this you are confirm taking

take note!!

payment method is by CASH DEPOSIT

and

shipping by POS LAJU





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