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FORM PEMESANAN / PEMBELIAN
Kolom-kolom bertanda (* merah) wajib diisi.
Masukkan Angka/Jumlah Produk yg dibeli dalam Kotak dibawah nama Produk.
Nama Lengkap Sesuai KTP
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No Anggota Melilea (khusus Member)
No Telp/HP yang bisa dihubungi
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Alamat Email (jika ada)
Alamat sesuai KTP / Alamat Pengiriman
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Country / Region
Street Address = Diisi nama Jalan/Alamat sesuai KTP | City = Kota | State/Province/Region = Kabupaten/Propinsi | Postal/Zip Code = Kode Pos
Soya Organik 500 Gr
Isi jumlah yg dibeli
Greenfield Organic 4 oz
Isi jumlah yg dibeli
Greenfield Organic 16 oz
Isi jumlah yg dibeli
Apple Orchard Organic 400 Gr
Isi jumlah yg dibeli
Herbal Milk Celanser 120 ml
Isi jumlah yg dibeli
Soothing Milk Cleanser 120 ml
Isi jumlah yg dibeli
pH Balance Toner 120 ml
Isi jumlah yg dibeli
Gentle Exfoliant 30 ml
Isi jumlah yg dibeli
Intensive Nourisher 15 ml
Isi jumlah yg dibeli
Revitalizing Cream 30 ml
Isi jumlah yg dibeli
Oxy Intensive Cream 30 Gr
Isi jumlah yg dibeli
White Illuminating Essence 35 ml
Isi jumlah yg dibeli
Facial Mask (Comb. to Oily Skin) 59 ml
Isi jumlah yg dibeli
Facial Mask (Normal to Dry Skin) 59 ml
Isi jumlah yg dibeli
Hydrating Facial Gel 117 ml
Isi jumlah yg dibeli
Advance Toning System 1 Set
Isi jumlah yg dibeli
Komentar/Keterangan lain (jika ada)
Tujuan Transfer
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Silahkan Pilih
BNI 0050532399
Mandiri 1410007790926
Mandiri 1410007683451
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