Order Form

*Name:

*Email:

Contact number: (Required if you are doing meet-ups)

*Distribution mode:
Normal (SGD$2.50)
Registered (SGD$2.50+$2.40=SGD$4.90)
Meet-ups (only available in the East at additional SGD$1.00)

*Bank account type: (eg. POSB savings/current)

*Bank account number:

*Item #1: (Please enter the item code)

Colour: If applicable:

*Quantity:
1 2 3 4 5

Item #2: (Please enter the item code)

Colour: (If applicable)

Quantity:
1 2 3 4 5

To order more items, please enter the details here, in the format shown above. Include the item code, colour (if applicable) and quantity:

*Total price: (Price of item #1) + (Price of item #2) + ($2.50 for postage) + ($2.40 for optional registered mail)

Comments:

Payment Method
Payments made only through ATM Funds Transfer, POSB Savings to Momo Couture's bank account. Please remember to keep the receipt and fill in the form below after payment is made.
Please make payment only after we have sent a confirmation email asking you to do so upon receiving your order form.

*Email address:

*To POSB savings Account: 136-35678-0:
Confirm

*Amount paid:

*Transaction Reference No.:

Date and time of transaction:
Month Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 � Hour 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 Minute : 00 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59

Address:

(Please indicate your mailing address if you have selected unregistered/registered postage as distribution mode)

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Momo Couture provides a range of fashionable accessories, bags and clothes at reasonable prices.




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Credits

Designer: Braix23

Images: MEG