Order Form

Follower?	Yes No Return Customer
Name:
Contact No.:
Email Address:
Location / Address (for postage/delivery)
Order 1: (Brand/Size/Trial/Jumbo/Quantity)
Order 2: (Brand/Size/Trial/Jumbo/Quantity)
Order 3: (Brand/Size/Trial/Jumbo/Quantity)
Booking?	ASAP This Week Next Week Upon available
Delivery	Self Collect Delivery (within KL) Via Post
Payment	Maybank CIMB Muamalat COD (self collect)
Remark:

Form provided by Freedback.