Send your order form to jac-a-ass@hotmail.com
*Name: | |
*Email Address: | |
*Tel. No. : | |
*Shipping Address: | |
*Product Code: | 1) 2) 3) 4) 5) 6) 7) |
Remarks on Order: | (Gift Wrap, Special Requests, cash on delivery, etc) |
Registered Mail: | Yes / No (Delete where appropriate) |
*Mandatory Field
*We will send a confirmation email upon receiving the form.
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