EmailMe Form - Order Form

Name *
First Last
Please enter in your full name.
Phone *
Please enter in a valid local phone number.
Email *
Please enter in your email address.

Confirm Email
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Please ensure that you have entered your full address.
Items *
example: Item #1 Leather Skater Skirt (Red) $28.50 (link)
Please ensure everything is in detail to avoid misconceptions.
Payment Mode *
Bank Account Number to be given via confirmation email by us.
Delivery Mode *
Postage Fees depends on weight so confirmed pricing will be shown on item details. Please refer.
Do you agree with the Terms & Conditions of MYJH? *
Yes
Comments?
Anything for us to take note of?