| Member's Full Name *
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Member's Code *
(This side for register Member of SOPHIE PARIS MALAYSIA GROUP only)
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| Member's Mobile Number *
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| Recipient's Full Name *
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| Recipient's Delivery Address *
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| Recipient's Home/Office Tel Number
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| Recipient's Mobile Number *
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Product Code/Qty/Page No. *
(eg : DSM997/1/m/s 22) or DSM997/1/m/s 22, LT695W/1/m/s 38 (if more than 1 item)
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Total (RM) *
(include cost for Pos Laju)
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| Payment Method
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Internet Banking (Maybank2u)
Internet Banking (AmOnline)
Interbank Fund Transfer (CIMB Clicks / etc)
Cash Deposit at ATM Machine
Cash Deposit at Bank Counter
Fund Transfer at ATM Machine |
PROOF OF PAYMENT
(Please "copy & paste" proof of payment here if you are making payments "online")
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| Payment Confirmation
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YES, I Confirm my Order and Commit to make payment within 24 hours from order date. (Joy Buyer AND Unpaid Buyer / Customer will be BLACKLISTED) |
| How do you hear about us
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