Order Format form

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Title: Paid and ordered



Name/Blogspot nick:



Email address:



Account type and no.:


Item #1


Item name: Pi Be Rational


Colour: Asphalt


Size: small (mens)


Qty: one


Url: http://www.snorgtees.com/piberational-p-563.html?osCsid=457ac3bb9cabb8c7f7bbea93161a4f76


Alternative: (Same or lower value)


Price in USD: US$16.95


Item #2


Item name:


Item code:


Colour:


Size:


Qty:


Url:


Alternative:


Price in USD:


Total in USD:




Total in SGD: [(Price in USD after 10%


discount) x 1.53] + US$5.00 =




Paid via: ATM / IBanking


To account: POSB/UOB


Account no.:


Date & Time of transfer:


Reference No:

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