Bellaxara: Order Form

P/S : jika tempat anda berdekatan dgn rumah admins & boleh mengambil secara terus tanpa menggunakan Poslaju,sila isi order form dan tulis di komen bahawa anda mahu mengambil tanpa mengguna pos laju.

This contact form was created by Freedback.

Important!!

-Sila semak email anda termasuk spam/junk folder dlm masa 24jam selepas submit order form.pastikan email address anda betul.

Please Email US Payment Details Once Payment Made. ( by sending new email or reply email from bellaxara)
Details u need to give us
- Bank, Date, Time, Amount
- Attachment of Slip, Receipt , or print screen of online transfer receipt

Name(full name)
Address
Email Address:
Contact Number
Code item
i can make payment by	12hours 24hours 48hours
comments

	Important!! -Sila semak email anda termasuk spam/junk folder dlm masa 24jam selepas submit order form.pastikan email address anda betul. Please Email US Payment Details Once Payment Made. ( by sending new email or reply email from bellaxara) Details u need to give us - Bank, Date, Time, Amount - Attachment of Slip, Receipt , or print screen of online transfer receipt