Agent Order Form
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| Agent Name
*
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| Email Address
*
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| Contact Number
*
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Pos Laju Consignment
Note (Rm 3)
*
| YES ( Posting to Customer Address) NO (Posting to Agent Address)
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ORDER NO 1
(Code Item)
*
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Customer Name,
Address,
Contact Number
*
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ORDER NO 2
(Code Item)
*
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Customer Name,
Address,
Contact Number
*
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ORDER NO 3
(Code Item)
*
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Customer Name,
Address,
Contact Number
*
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ORDER NO 4
(Code Item)
*
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Customer Name,
Address,
Contact Number
*
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ORDER NO 5
(Code Item)
*
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Customer Name,
Address,
Contact Number
*
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BY SUBMIT THIS FORM I AGREE:
* TO MAKE PAYMENT WITHIN 24 HOUR AFTER ORDER CONFIRMATION
* NO CHANGE OR CANCEL ORDER AFTER PAYMENT DONE
* MONEY RETURN IF NO STOCK
* SELLER NOT RESPONSIBLE FOR PARCEL AFTER POSTING OUT.
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Image Verification
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EMF Online Order Form
EMF Online Order Form