ORDERING PRODUCT /PAYMENT



ENTER


ACC NUMBER - PUBLIC BANK BERHAD

JUARA GENERAL SUPPLIES AND SERVICES
ACC. NUMBER:- 3152580217


(BANK INI YOUR MONEY AT THE NEAREST BRANCH AND SEND YOU BANK SLIP TO (FAX) 088-219770
OR CALL FOR MR JOHNNY JUINIS - AT THIS NUMBER 019-5386184..YOUR PREPAID VOUCHERS AND DISCOUNT VOUCHERS AT THE VALUE OF RM180.00 WOULD BE SENT TO YOU ONCE PAYMENT IS VALIDATED. ) THANK YOU.)


FOOD PREPAID PROGRAM / SOUTHERN BAKERY

RM168.00 X ........ = RM...........

NAME : ___________________________

IC NO :___________________________

TEL /HP NO:_______________________

ADDRESS :_________________________

EMAIL :__________________________

USERNAME :________________________

PASSWORD :________________________

INTRODUCER BY : JOHNNY JUINIS

IMMEDIATE UPLINE: JOHNNY JUINIS

DATE : ___________________________