Fragranceonline.com Order Form

 


Name

 

Name

 

Mailing Address

 

 

Delivery Address    (If different from mailing address)

 

 

 

 

 

Postal code

 

 

 

Telephone  
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Remarks  
 

 

If paying by credit card, please fill in the details below and Fax to us at :  ( 603 ) 40451989

Please tick where appropriate : Visa Card Master Card  American Express 

 

Name on Card

 

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Card Expiry Date

 

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Signature (Card member's as per credit card account )  


If paying by Check or Money Order, please make payment payable to: NSCashpoint SdnBhd

               Mail Payment together with completed order form to :

NS Cashpoint Sdn. Bhd
No.3-2, 2nd Floor, Jalan 15/48A,
Sentul Raya Boulevard
Off Jln. Sentul,
51000 Kuala Lumpur,
Malaysia

List Your Items Here

 

Item Description

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Price

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Date of Order : [________________]

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