DERMA PROSKIN EXPRESS
Customer Order Form
Good Day Valued Customer!
Full Name:
Email Address:
Complete Shipping Address:
Contact No(s):
Sulid ID (If any):
Items you wish to buy and their quantity:
Do you agree with our Terms & Conditions?
YES, I have read the FAQ'S and I promise to comply with it.
I wish to receive a discount on my next purchase, so I promise to leave a feedback when I get my ord
Yes!
No
Payment will be done thru:
BDO (Banco De Oro Over the Counter Deposit)
GCASH (Not GCash Remit)
I know that the payment CUT OFF time is until 12PM only
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YES
