Product Order Form
For Cebu-Philippines Residents please proceed by filling up the form below And For USA & Canada Residents please click here

Product Selection:

Payments will be through our Electronic SMARTMONEY 5577 5140 9535 6103, Name: MANUEL M LEUTERIO at any Smart Wireless Center (SM or E-Mall) or Smart Money Center located at your convenience place. Our flat rate change 1US$ = Ph 50.00

Payment Breakdown: a) FREIGHTAGE/HANDLING COST: Ph100.00 pesos + Customers Price or Distributors Price for Cebu City, Mandaue City, Talisay City and Lapulapu City in the Province of Cebu-Philippines. Once we received the payment, You will be informed or notified ASAP when we will send for the delivery of the Products you have ordered. Thank you

Quantity

Choose a product

Address:

First Name

Last Name

Address 1

Address 2

City/Street

State/Province

Zip

Telephone no./Mobile phone no.

Email Address

Optional: For the meantime we will not accept credit cards. Sorry for the inconvenience, we will inform later once our machine is activated. Thank you for the consideration.

Credit Card

Card Number

Expiration

Referrals:(name,home or office address ,e-mail address,home or office tel no. or any contact details)

Referrals/Comments/Suggestions: