New Customer Registration Form

Customer Details:
Full Name*

First NameLast Name
PEP name/store code
Check your PAXI pickup point here:
Aramex Address (if applicable)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number (to receive collection sms)*
Format: (000) 000-0000.
E-mail
example@example.com
What are your skin issues?
Customer suggestions and reviews:
My Products*
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Kojic acid soap
80.00ZAR Quantity
Item subtotal:0.00ZAR



Turmeric face mask
Cleansing & Oil-Control Brightening & Repairing Anti-Allergy & Anti-Acne

60.00ZAR Quantity



Delivery options
Please select your preferred delivery option below

109.00ZAR QuantityDelivery option (South Africa)
Item subtotal:0.00ZAR



Total

0.00ZAR
Attach Proof of Payment *

Banking details: Account no: 2373380079 (Capitec) Account holder: SA MCAKA Reference: Your name
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