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Products
GONG XI FA CAI 2010
Hari Raya Aidilfitri 2009
DE MERRY CHRISTMAS 2009
De Opening
De Special Buy
De Flower Bouquet
De Artificial Flower
De Special Occasion
De Flower Fruit Basket
De Condolence
De Baby Gift
De Hand Bouquets
De Revival
Wedding
De House Hold
VALENTINE'S DAY
TO MY PARENT

 
 
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Main  > Contact Us  >  Order Form


 

Order Form

Hot Line : 603-5882 4290
Fax to 03-5882 4289 / 03-5882 8019
Website : www.dememory.com
Email : dememory@dememory.com 
 

  • Please provide e-mail address for promotion announcements.

  • Please complete the details as indicated in block letters or type.

  • Please photocopy this order form if you have more than one order.

  • Please placed your order 2 days in advance.

 

Please fill in all fields marked with a *
  Customer No. :
  To : DeMEMORY Hamper & Florist Sdn. Bhd.
(Co. No. 746968-X)
  Attention :
22G, Jalan Bandar 15, Pusat Bandar Puchong,
47100 Selangor Darul Ehsan.
  Date Of Order :
  No. of Pages :
* Name
  I.C. No. :
* Email :
  Address :
  Company Name &
  Address
* Tel.:
  Fax :
  Contact Person :
  Signature :
   

  ORDER INSTRUCTIONS

  Product Code :
  Unit Price :
  Quantity :
  Deliver to (Name) :
  Address (House/Office) :
  Postal Code :
  Tel :
  Mobile :
  Delivery Date : Between
  Delivery Date : To
  Delivery Time :
  From (Name) :
  Message (if any) :
 

  PAYMENT INSTRUCTIONS

  Total Amount Order (RM) :
  To Be Paid By :
If payment by card.  
  Card No. :
  Date Of Order :
  Expiry Date :
  Cardmember's Name :

              

         
         
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