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Name
Prefix
First
Last
Suffix
Home Delivery
(Home Delivery will be applicable at a postage charge of minimum S$9.15)
 Yes! Deliver To My Home! 
 No Thanks! I Will Collect At The InSPAra Outlet 
Address (For Home Delivery)
Street Address
Address Line 2
City
State / Province / Region
Postal / Zip Code
Country
Email
Phone Number
REFRESHING RANGE PRODUCTS
 Bath and Shower Gel 
 Moisturizing Lotion 
 Sugar Scrub 
 Body Mist 
 Shower Gel 
 Bath Salt 
 Whole Set 
HEALING RANGE PRODUCTS
 Bath and Shower Gel 
 Moisturizing Lotion 
 Salt Scrub 
 Body Mist 
 Shower Gel 
 Bath Salt 
 Whole Set 
ENERGIZING RANGE PRODUCTS
 Bath and Shower Gel 
 Moisturizing Lotion 
 Salt Scrub 
 Body Mist 
 Shower Gel 
 Bath Salt 
 Whole Set 
Transaction Number
Amount Paid
(Please Remember to include postage charges for home delivery and
please pay the exact amount as no change will be given)
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