ORDER FORM

Title:	Mr                 Ms
Full Name:
NRIC:
Mobile Phone No.:
Email Address:
Delivery Address:
Your Order:	Accessories                 Bags                 Clothing                 Jewellery                 Others
YOUR ORDER (Pls specify Item Code/Description, Quantity, Colour, etc.)                 (Item 1):
(Item 2):
(Item 3):
Method of Shipping:	Pos Laju (default)
Comments/Requests:
I hereby confirm all the information above is accurate and that I agree with all the terms & conditions as stipulated on the website.	Agree                 Disagree

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