Name:
Mobile (Tel)
Contact person/ Mobile (for receiving of goods)- if differs from above
Delivery address (FREE delivery to Singapore & Malaysia)
Preferred Time of Delivery
Email Address:
Products (For single quantity per item only)
Quantum Energy Mat (S$880/ RM2,150)
Quantum Energy Seat (S$880/ RM2,150)
Quantum Energy Bed (S$880/ RM2,150)
Quantum AloeGel (S$120/ RM290)
Quantum Power (4 pieces) (S$70/ RM150)
Quantum Shield (6 pieces) (S$70/ RM150)
Quantum Pen (S$120/ RM290)
Premium Quantum Pendant (S$120/ RM290)
Quantum Charger (S$120/ RM290)
Quantum BeautyBar (S$70/ RM150)
Quantum Pendant (S$70/ RM150)
Quantum Flask (S$70/ RM150)
Quantum Bracelet (S$70/ RM150)
Quantum Bracelet (Gold) (S$70/ RM150)
Quantum Watch (S$360/ RM860)
Quantum Spa (S$410/ RM1,000)
Quantum Spa Cartridge (S$70/ RM150)
Quantum Water (S$760/ RM1,860)
Quantum Water Cartridge (S$180/ RM430)
Quantum Knife (S$70/ RM150)
Quantum Kettle (S$70/ RM150)
Quantum Toothpaste (S$120/ RM290)
Quantum Perfume (S$120/ RM290)
Quantum Shaker (S$70/ RM150)
Product's name/ quantities (For multiple quantities per item)
Preferred payment method
Bank deposit (Singapore) - DBS
Bank deposit (Malaysia) - Maybank
Paypal
Acknowledgement
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