Gurlfriend: Order Form

Gurlfriend Order Form
Last name *
First name *
Middle initial
Shipping Address: *	<br /> (house number, street, town/city, province)
Contact number: *
E-mail address: *
Order: *	<br /> Be sure to check if the item codes are correct. Please indicate the quantity.
Payment options: *	GCash BPI ML Kwarta Padala Western Union Reminder: The shipping fee will be added to the total amount.