Crystal Ferris Wheel Pendant Order Form
Name
First
Last
Email
Pendant Color Choice
If purchasing more than one piece, please state under "others' the color & respective quantity
Colorful
Violet
Aquamarine Blue
Rose Pink
Hyacinth Red
other:
Total Quantity
Orde Date
MM
/
DD
/
YYYY
Delivery Address
Street Address
Street Address Line 2
City
Region
Postal / Zip Code
Afghanistan
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Algeria
Andorra
Angola
Antigua & Deps
Argentina
Armenia
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Dominican Republic
East Timor
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Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia
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Ghana
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Morocco
Mozambique
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Namibia
Nauru
Nepal
Netherlands
New Zealand
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Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russian Federation
Rwanda
St Kitts & Nevis
St Lucia
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Samoa
San Marino
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Saudi Arabia
Senegal
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Singapore
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Slovenia
Solomon Islands
Somalia
South Africa
Spain
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Sudan
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Swaziland
Sweden
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Syria
Taiwan
Tajikistan
Tanzania
Thailand
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Tonga
Trinidad & Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
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Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
Other
Country
Contact Number
Choice of delivery
Normal Mail - FREE
Registered / Recorded Mail - Additional $2.24
Choice of Payment
to POSB current account 821190509
to UOB savings account 1301367800
OCBC savings account 5699003280
Credit/Debit cards through Paypal made to paypal@simplicitystore.net (registered mail at addtional S$2.24 is compulsory for this payment option, kindly add on your total)
Any other special instructions
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