Parisilk Electronics and Computers Pte. Ltd.

Order Form

Dear Valuable Customer,

Thank you for choosing to place your order with us online. Please fill up the "Order Form" below and we will get to work immediately in processing your order. Please also fill up as much of your personal particulars as possible in order for us to include you in our customer database.

Name:*

Organization:

Address:*

City/State:

Country:*

Telephone:*

Fax:

Handphone/Pager:

Email:*

Preferred Response:

Telephone

Fax

Your Order:*
(include the Brand name, Model No. and description of the item)

Your comments / Suggestions

Preferred date of delivery

Preferred time of delivery

Payment mode:

Cash/Nets
(payable at our retail outlet 2 days before delivery)

Cash/Cheque
(payable upon delivery)

Your opinion of this service:

Excellent

Good

Needs Improvement

Note: * indicates compulsory entries