EmailMeForm
COCONUT GOLD ORDER FORM
Summary of Orders
Indicate quantity and description
NOTE: The seller will still confirm availability of your order/s.
Payment Options
*
GCASH 0906 226 6818
BDO
BPI Savings
METROBANK
PAYPAL (service charge applies)
CASH - PICK UP AT UP VILLAGE/
CASH - PICK UP AT OCC
WESTERN UNION
LBC
Select one mode of payment only.
A copy of the deposit slip must be sent through email or MMS. Photo/Scanned copy will do.
I agree that sending out this order form means that my order is final and cannot be cancelled anymore.
*
YES!
Client Information
Full Name
*
Shipping Address
*
Please provide the complete shipping address. If the item is for pick up write "NA"
The shipping address is required to determine your shipping fees.
Cellphone Number
*
Email Address
*
THANK YOU for taking the time to fill up this form!
We will get in touch with you as soon as possible.
For any immediate concern, you can reach us at 0917-5598910.
Powered by
EMF
Online Order Form
Report Abuse