PWX Customer Order Request
Please fill up the information below to proceed with your order.
Sign in to Google to save your progress. Learn more
First Name *
Last Name *
Mobile Number *
Email Address *
Unit Number, Building, Street Address *
Barangay/Municipality *
City *
Products to Order - Please indicate item name and quantity per product *
How would you like to get your order?
 *
If you have a preferred delivery date, please indicate so here. *Requested delivery dates should be at least 24 hours from date and name of acknowledgement of order and complete payment. 
MM
/
DD
/
YYYY
Mode of Payment *
Consent *
Required
Gifting 
Is this order a gift for someone?
Recipient's First Name
Recipient's Last Name
Recipient's Mobile Number
Recipient's Email Address
Recipient's Unit Number, Building, Street Address
Recipient's Barangay/Municipality
Recipient's City
Customized Gift Card Message (150 characters only)
Optional. Please include company of sender if applicable.

Terms & Conditions

1. Delivery charges apply.

2. PWX reserves the right to reschedule deliveries in case of inclement weather or general traffic disturbances that are beyond its control.

3. This service is available for deliveries in the Greater Metro Manila Area. 

Thank you for your order request!

We will be emailing you to confirm your order and to provide billing details. 

Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms