ORDER FORM


___________________________________________________________________________________________
NAME:


EMAIL:
ADDRESS:
ITEM CODE:
ALTERNATIVE CHOICE (in case it's out-of-stock):
POSTAGE:
I-Banking-(Transaction no., IB nickname, time of transfer):

FOR ATM TRANSFER, PLEASE ATTACH A SNAPSHOT OF YOUR TRANSACTION RECEIPT FOR VERIFICATION PURPOSE AND EMAIL IT TO ORDERS@DEIGRATIA-SG.COM
REMARKS (Discount Code etc.):

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