ORDER FORM

Name:
Contact No :
Mailing Address :
Email Address:
Item No 1 :	Gel Heel Grips (RM 11.90) Gel Soft Spots (RM 11.90) Ribbed Non-slip Solette Ladies (RM 9.90) Safe Grips (RM 16.90) Fresh Foot Powder (RM 12.90) White Recolour (Leather&Canvas Polishing)RM 19.90 Insoles Foam Deodoriser kids 09 (RM 9.90) Insoles Foam Deodoriser kids 10 Insoles Foam Deodoriser kids 11 Insoles Foam Deodoriser kids 12 (RM 9.90) Insoles Foam Deodoriser kids 13 (RM 9.90) Insoles Foam Deodoriser kids 1 (RM 9.90) Insoles Foam Deodoriser Adult 2 Insoles Foam Deodoriser Adult 3 (RM 10.90) Insoles Foam Deodoriser Adult 4 Insoles Foam Deodoriser Adult 5 Insoles Foam Deodoriser Adult 6 Insoles Foam Deodoriser Adult 7 Insoles Foam Deodoriser Adult 8 Insoles Foam Deodoriser Adult 9 Insoles Foam Deodoriser Adult 10 (RM 10.90) Insoles Foam Deodoriser Adult 11 (RM 10.90) Insoles Foam Deodoriser Adult 12 (RM 10.90) Insoles Cork Adult 2 (RM11.90) Insoles Cork Adult 3 (RM11.90) Insoles Cork Adult 4 (RM11.90) Insoles Cork Adult 5 (RM11.90) Insoles Cork Adult 6 (RM11.90) Insoles Cork Adult 7 (RM11.90) Insoles Cork Adult 8 (RM11.90) Insoles Cork Adult 9 (RM11.90) Insoles Cork Adult 10 (RM11.90) Insoles Cork Adult 11 (RM11.90) Insoles Cork Adult 12 (RM11.90)
Qty (Item No 1):	1 2 3 4 5 6 7 8 9 10
Item No 2 :	Gel Heel Grips (RM 11.90) Gel Soft Spots (RM 11.90) Ribbed Non-slip Solette Ladies (RM 9.90) Safe Grips (RM 16.90) Fresh Foot Powder (RM 12.90) White Recolour (Leather&Canvas Polishing)RM 19.90 Insoles Foam Deodoriser kids 09 (RM 9.90) Insoles Foam Deodoriser kids 10 Insoles Foam Deodoriser kids 11 Insoles Foam Deodoriser kids 12 (RM 9.90) Insoles Foam Deodoriser kids 13 (RM 9.90) Insoles Foam Deodoriser kids 1 (RM 9.90) Insoles Foam Deodoriser Adult 2 Insoles Foam Deodoriser Adult 3 (RM 10.90) Insoles Foam Deodoriser Adult 4 Insoles Foam Deodoriser Adult 5 Insoles Foam Deodoriser Adult 6 Insoles Foam Deodoriser Adult 7 Insoles Foam Deodoriser Adult 8 Insoles Foam Deodoriser Adult 9 Insoles Foam Deodoriser Adult 10 (RM 10.90) Insoles Foam Deodoriser Adult 11 (RM 10.90) Insoles Foam Deodoriser Adult 12 (RM 10.90) Insoles Cork Adult 2 (RM11.90) Insoles Cork Adult 3 (RM11.90) Insoles Cork Adult 4 (RM11.90) Insoles Cork Adult 5 (RM11.90) Insoles Cork Adult 6 (RM11.90) Insoles Cork Adult 7 (RM11.90) Insoles Cork Adult 8 (RM11.90) Insoles Cork Adult 9 (RM11.90) Insoles Cork Adult 10 (RM11.90) Insoles Cork Adult 11 (RM11.90) Insoles Cork Adult 12 (RM11.90)
Qty (Item No 2):	1 2 3 4 5 6 7 8 9 10
Item No 3 :	Gel Heel Grips (RM 11.90) Gel Soft Spots (RM 11.90) Ribbed Non-slip Solette Ladies (RM 9.90) Safe Grips (RM 16.90) Fresh Foot Powder (RM 12.90) White Recolour (Leather&Canvas Polishing)RM 19.90 Insoles Foam Deodoriser kids 09 (RM 9.90) Insoles Foam Deodoriser kids 10 Insoles Foam Deodoriser kids 11 Insoles Foam Deodoriser kids 12 (RM 9.90) Insoles Foam Deodoriser kids 13 (RM 9.90) Insoles Foam Deodoriser kids 1 (RM 9.90) Insoles Foam Deodoriser Adult 2 Insoles Foam Deodoriser Adult 3 (RM 10.90) Insoles Foam Deodoriser Adult 4 Insoles Foam Deodoriser Adult 5 Insoles Foam Deodoriser Adult 6 Insoles Foam Deodoriser Adult 7 Insoles Foam Deodoriser Adult 8 Insoles Foam Deodoriser Adult 9 Insoles Foam Deodoriser Adult 10 (RM 10.90) Insoles Foam Deodoriser Adult 11 (RM 10.90) Insoles Foam Deodoriser Adult 12 (RM 10.90) Insoles Cork Adult 2 (RM11.90) Insoles Cork Adult 3 (RM11.90) Insoles Cork Adult 4 (RM11.90) Insoles Cork Adult 5 (RM11.90) Insoles Cork Adult 6 (RM11.90) Insoles Cork Adult 7 (RM11.90) Insoles Cork Adult 8 (RM11.90) Insoles Cork Adult 9 (RM11.90) Insoles Cork Adult 10 (RM11.90) Insoles Cork Adult 11 (RM11.90) Insoles Cork Adult 12 (RM11.90)
Qty (Item No 3):	1 2 3 4 5 6 7 8 9 10
Item No 4:	Gel Heel Grips (RM 11.90) Gel Soft Spots (RM 11.90) Ribbed Non-slip Solette Ladies (RM 9.90) Safe Grips (RM 16.90) Fresh Foot Powder (RM 12.90) White Recolour (Leather&Canvas Polishing)RM 19.90 Insoles Foam Deodoriser kids 09 (RM 9.90) Insoles Foam Deodoriser kids 10 Insoles Foam Deodoriser kids 11 Insoles Foam Deodoriser kids 12 (RM 9.90) Insoles Foam Deodoriser kids 13 (RM 9.90) Insoles Foam Deodoriser kids 1 (RM 9.90) Insoles Foam Deodoriser Adult 2 Insoles Foam Deodoriser Adult 3 (RM 10.90) Insoles Foam Deodoriser Adult 4 Insoles Foam Deodoriser Adult 5 Insoles Foam Deodoriser Adult 6 Insoles Foam Deodoriser Adult 7 Insoles Foam Deodoriser Adult 8 Insoles Foam Deodoriser Adult 9 Insoles Foam Deodoriser Adult 10 (RM 10.90) Insoles Foam Deodoriser Adult 11 (RM 10.90) Insoles Foam Deodoriser Adult 12 (RM 10.90) Insoles Cork Adult 2 (RM11.90) Insoles Cork Adult 3 (RM11.90) Insoles Cork Adult 4 (RM11.90) Insoles Cork Adult 5 (RM11.90) Insoles Cork Adult 6 (RM11.90) Insoles Cork Adult 7 (RM11.90) Insoles Cork Adult 8 (RM11.90) Insoles Cork Adult 9 (RM11.90) Insoles Cork Adult 10 (RM11.90) Insoles Cork Adult 11 (RM11.90) Insoles Cork Adult 12 (RM11.90)
Qty (Item No 4):	1 2 3 4 5 6 7 8 9 10
Item No 5 :	Gel Heel Grips (RM 11.90) Gel Soft Spots (RM 11.90) Ribbed Non-slip Solette Ladies (RM 9.90) Safe Grips (RM 16.90) Fresh Foot Powder (RM 12.90) White Recolour (Leather&Canvas Polishing)RM 19.90 Insoles Foam Deodoriser kids 09 (RM 9.90) Insoles Foam Deodoriser kids 10 Insoles Foam Deodoriser kids 11 Insoles Foam Deodoriser kids 12 (RM 9.90) Insoles Foam Deodoriser kids 13 (RM 9.90) Insoles Foam Deodoriser kids 1 (RM 9.90) Insoles Foam Deodoriser Adult 2 Insoles Foam Deodoriser Adult 3 (RM 10.90) Insoles Foam Deodoriser Adult 4 Insoles Foam Deodoriser Adult 5 Insoles Foam Deodoriser Adult 6 Insoles Foam Deodoriser Adult 7 Insoles Foam Deodoriser Adult 8 Insoles Foam Deodoriser Adult 9 Insoles Foam Deodoriser Adult 10 (RM 10.90) Insoles Foam Deodoriser Adult 11 (RM 10.90) Insoles Foam Deodoriser Adult 12 (RM 10.90) Insoles Cork Adult 2 (RM11.90) Insoles Cork Adult 3 (RM11.90) Insoles Cork Adult 4 (RM11.90) Insoles Cork Adult 5 (RM11.90) Insoles Cork Adult 6 (RM11.90) Insoles Cork Adult 7 (RM11.90) Insoles Cork Adult 8 (RM11.90) Insoles Cork Adult 9 (RM11.90) Insoles Cork Adult 10 (RM11.90) Insoles Cork Adult 11 (RM11.90) Insoles Cork Adult 12 (RM11.90)
Qty (Item No 5):	1 2 3 4 5 6 7 8 9 10
Delivery Option 运送方式：	Airpak-express RM 8 Sabah & Sarawak RM14.50
Payment Via / 汇款详情：	Maybank: 1551 2704 9384 CHANG THAI THAI
Payment Slip (Copy & Paste from eBanking)/汇款账单（复制 & Paste）：
Amount Paid /汇款银： （Included Postage 包括邮费）
Term & Condition 条规:	I agreed to shoecareladyman.blogspot.com Purchases & warranty term & condition. Item sold are stricty no RETURNABLE or REFUNDABLE. 我同意shoecareladyman.blogspot.com采购。项目出售严格没有回收或偿还。

This online form was provided by Freedback.