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Saturday, January 8, 2011

Order Form












Name:




Email Address:




Phone No:




Address:




Item no




Delivery Method

Pos Laju (RM6 -East, RM9 West)

Pos Express (RM5 up to 2 pieces)




Payment Method

Maybank

Bank Islam

Bank Muamalat



if item not available, i want to cancel:

yes

no



if no,my alternative item:




Message & comment & suggestion:




Term and Condition:

I've Read,Understood and Agree the terms & conditions stated.










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Order Form

Name:
Email Address:
Phone No:
Address:
Item no
Delivery Method Pos Laju (RM6 -East, RM9 West) Pos Express (RM5 up to 2 pieces)
Payment Method Maybank Bank Islam Bank Muamalat
if item not available, i want to cancel: yes no
if no,my alternative item:
Message & comment & suggestion:
Term and Condition: I've Read,Understood and Agree the terms & conditions stated.
This HTML form was created by Freedback.