ORDER FORM |
TODAY’S DATE:__/__/__
ORDER NO.:______________
| COUNTRY OF DESTINATION: | _____________________________________________ |
| EXECUTING MEMBER: | _____________________________________________ |
| DELIVERY DATE: | _____________________________________________ |
| RECIPIENT ‘S NAME: | _____________________________________________ |
| RECIPIENT ‘S ADDRESS: |
_____________________________________________ _____________________________________________ _____________________________________________ _____________________________________________
|
| TELEPHONE NUMBER: | _____________________________________________ |
| FLOWERS/PRODUCT CODE: | _____________________________________________ |
| VALUE: | ___________RINGGIT MALAYSIA / FLEURINS /DOLLAR |
| MESSAGE: |
_____________________________________________ _____________________________________________ _____________________________________________
|
| MEMBERSHIP NO.: | 6063_________________________________________ |
| NAME: | AL’CAPRICORN FLORIST |
| ADDRESS: |
11
& 12, Jalan Cahaya 11, Taman Cahaya,68000 Ampang,
Selangor,
Malaysia.
Tel: 603-92855625 / 603-92864625
Fax: 603-92864625 / 603-92855625 |
| WEBSITE: | http://www.alcapricorn.com.my |
| EMAIL: | alice.alcapricorn@gmail.com |
| OTHER INSTRUCTIONS: | _____________________________________________ |