Combat Robot T-shirt Order Form
Order period
23 - 31 July 2013

Payment Dateline
31 July 2013

Method of collection:
All t-shirts can be collected from the collection counter from 7-13 October 2013 at National Science Centre.
Sign in to Google to save your progress. Learn more
Buyer Details
Name *
Full Name
Identification Number (Malaysian Citizen) / Passport Number (Overseas Participant) *
000000-00-0000
Contact Number *
Mobile Phone Number
Email Address *
Please provide a frequent used email address
T-shirt Order Details
Price List
1 piece : RM 30.00/pc
2-4 pieces : RM 25.00/pc
5 pieces & above : RM 20.00/pc
Number of quantity *
Size S
Please select the number of pieces
Size M
Please select the number of pieces
Size L
Please select the number of pieces
Size XL
Please select the number of pieces
Size XXL
Please select the number of pieces
Payment Method
Payment shall be made to:
NAME    : MYROBOTZ ENTERPRISE
A/C NO. : 5123 6116 2860
BANK    : MAYBANK  

Email the scanned transaction slip (or screen capture of the online confirmation) as proof of payment to combatrobot@myrobotz.com.my.

Collection slip will be emailed to you once the payment has been verified.

Payment Dateline: 31 July 2013
Mode of Payment *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms