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彰化縣養殖漁業發展協會訂購表單
匯款後請輸入下列表單資料及匯款後五碼,謝謝
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訂購商品名稱
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防疫海鮮~奶香文蛤10包入(含運1500)
防疫組合包~奶香文蛤三包+珍珠蚵二包
防疫海鮮~海鮮自由煮(含運1200)
防疫海鮮~虱目魚組合包(含運990)
Other:
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防疫海鮮~文蛤數量
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海鮮自由選~珍珠蚵數量
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訂單編號
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購買人
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匯款後五碼
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匯款日期
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