EmailMe Form - Mr Firdaus Halim(Maybank account : 1521-2519-8455)

Date you order *
DD / MM / YYYY
Example : 06/12/2012
Your Name
First Last
please insert your real name!
Your Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

make sure you insert correct address
Phone number *
please put your own number
Email *
put your correct address
Example : no 36, kampung parit bengkok, 86400 batu pahat, johor darul takzim
Quantity
How many phone case you want

RM10 for 1 unit Samsung case except galaxy tab
RM10 for 1 unit iProduct case except iPad
RM40 for 1 unit Galaxy tab
RM40 for 1 unit iPad
Type Of phone casing
iProduct
Samsung
Blackberry
Nokia
HTC
please choose what model of phone casing you want
your phone model
please state your model correctly
phone picture(if necessarily)
if you forget or dont know your phone model please upload your phone picture
your description or questions
leaves any problem or any questions you want to ask
Your Maybank2u resit(bank in resit) *
Please keep your resit when finish your bank in make sure your picture upload is crystal clear to us view