LAYAWAY FORM

LAYAWAY FORM

( Please be sure of your intention before availing the layaway program. )
Date Reservation
FULL NAME*

First NameLast Name
HOME ADDRESS*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
TELEPHONE NUMBER*

Area CodePhone Number
MOBILE PHONE NUMBER*

Country CodePhone Number
EMAIL ADDRESS
example@example.com
FACEBOOK URL
CHOSEN ITEM/ ITEMS TO LAYAWAY*
CHOSEN ITEM/ ITEMS TO LAYAWAY*
PAYMENT METHOD*

CASH ( MEET UP )BANK DEPOSITLBC PERA PADALAPALAWAN EXPRESS PADALACEBUANA LHUILLIERMLHUILLIER
SHIPPING METHOD*

PICK UP ( MEET UP )LBCJRSOTHERS ( 2GO / ABEST /
PAYMENT AGREEMENT DATE

DP OF 30%1ST PAYMENT2ND PAYMENT3RD PAYMENT4TH PAYMENTFIFTH PAYMENTSIXTH PAYMENT
SIGNATURE / DATE
Should be Empty: