Order Form

Please fill in the form below and we'll get to you soon.

Name (CAPITAL LETTER):
Email Address:
Income Monthly (RM)	0-500 500-1000 1000-2000 2000-3000 3000-5000 5000 above
Contact No
Postal Address
Postcode
City
State
Your Order  (Item Name, Specification, Quantity) *One item per line.
Payment through Cash Deposit / Bank Account can be made to this Maybank Account: 123456789012
Payment Method	Postal Money Credit Card Cash Deposit/ Bank Account
Credit Card No
Expiry Date (mm/yyyy)
Card CVC
	I have read and agree to the terms and conditions.