Order Form
Full Name *
Complete Shipping Address

Street Address

Address Line 2

City
State / Province / Region

Postal / Zip Code
Country
Phone Number *

### 		-
### 		-
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Email *
Order (Item Code) *
Quantity
Size (Optional)
leave blank if it has only 1 size
Color (Optional)
leave blank if the item has 1 color
Mode of Payment *
 GCash 
 Unionbank Deposit 
 Western Union 
 Paypal (Php) 
 COD (Meet - Up) 
Select only one
Date of Payment *

MM 		/
DD 		/
YYYY
2 days reservation only - Please pay on or before the cut-off date
Terms
 I agree that I will pay on the date I specified 
 I will add shipping fee to the payment 
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