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Zahra Chocolate House
Order Form
Saturday, June 29, 2013
ORDER FORM
Name :
Tel.No :
Email Address:
Pilihan Produk :
Produk Coklat
Fer'White
Bedak Tanaka
Aura White
Shiseido Black Mask
Rumpai Laut
Maixara C-Sential
Kuantiti :
Delivery Address :
Tarikh Tempahan
Tarikh Penghantaran
Keterangan produk(jenis/inti/kuantiti/warna/bentuk dll :
Nama :
Rashidah Binti Mohd Amin
Bank : Maybank Berhad
No.Acc :
156235003384
Nama :
Zahra Chocolate House
Bank :
CIMB
No.Acc : 0602-000042-4109
HUBUNGI : 012-8125182
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