Cocoon Culture No.47

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CC Ordering Form No. 0x67f0822e


Please use the form below to place your order. Note that all fields have to be completed manually, as there is no automation or script behind this form. Default values have been entered for guidance.

 

CC Ordering Form No.0x67f0822e

Hi, I would like to order the following items :

Item ID

How Many ?

Description

Item Price

Sub Total

Post & Package :

Grand Total :


Method of payment : Credit Card SWIFT Bank Giro Postal Order

Transaction details :

Please send this stuff to the following address :

Last Name :

Delivery Address :

Contact info. (e-mail v telephone) :

Comments :

 


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