Order Form

Name

Email

Model

Blouse Eksklusif ( Kod FB, FC )

T Shirt Muslimah ( Kod FT )

Blouse Eksklusif ( Kod FD, FY , FZ )

Blouse Eksklusif ( Kod FE, FJ dan FL)

Jubah Eksklusif , Abaya, Denim ( Kod CA, RA dan JA )

Jubah Denim ( Kod JB)

Jubah Lycra ( Kod LA )

Skirt Labuh Eksklusif ( Kod SA)

Baju Kurung Cotton Bermanik ( Kod GA)

Baju Kurung Cotton Tiada Manik ( Kod GB)

Pakaian Kanak-Kanak (Kod B)

Kod Number

Quantity

Delivery Address

MayBank

Others (Please stated bank name)

Payment Date

DD

/

MM

/

YYYY

Time

Never submit sensitive information such as passwords. Report abuse

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20