No 3 -1 & 3 -2, 
Jalan 3/62A,
Bandar Menjalara,
52200 Kepong, Kuala Lumpur,
Malaysia
Tel: 603-62771497 Fax: 603-62771498 
Email:lasport@pc.jaring.my


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HOW TO ORDER

For security reasons, we do not process credit card payments through the Internet. You can print the form below, fill in the details and fax it or send by mail, accompanied by the payment required, to the address above.

 

ORDER FORM

NAME:  
ADDRESS :  
   
POST CODE:  
CITY:  
CONTACT TEL:  
FAX:  
BEST TIME TO CONTACT:  
EMAIL:  

 

 

ORDER FORM:

 ITEM NO:

    UNIT PRICE:

  QUANTITY

  TOTAL (IN RM)
       
       
       
       
       
       
       
       
       
       
       
       
       
       

GRAND TOTAL:




MODE OF PAYMENT: CHEQUE BANKER'S DRAFT TELEGRAPHIC TRANSFER 
(please TICK whichever applicable).



 



DATE:.......................................



 



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