EmailMeForm
付款表格/Payment
名字/ Name
*
手机号码/Handphone
*
付款类型/ Payment Type
*
Please select
支付宝充值 / Alipay Reload
代购 / Purchase Payment
付款方式/Payment Method
*
Please select
CIMB Bank - 7034682463 - BONG PUI YUN
Hong Leong Bank - 02750314415 - BONG PUI YUN
MayBank - 161016101843 - BONG PUI YUN
Public Bank - 6329446615 - BONG PUI YUN
付款金额/Payment Amount
*
付款日期/Payment Date
*
DD
/
MM
/
YYYY
日 / 月 /年
付款收据/Bank In Slip
*
(只限/Only .jpg, .png 和 .pdf)
邮件/ E-mail
*
支付宝账号/Alipay ID
充值支付宝请在这填写资料
Alipay reload please fill up detail
支付宝密码/Alipay Pass.W
充值支付宝请在这填写资料
Alipay reload please fill up detail
备注/Remark
Powered by
EMF
Survey
Report Abuse