ORDER FORM

Please submit the form only AFTER payment has been made. POSB Savings 209-33541-7.  Please make sure the ATM Machine is capable of producing the receipt.

Do not select the VIP slot unless you were notified that you have won.

Name:
Email Address:
Contact Number
ALL friend(s)'s names and contact numbers
Preferred FIRST choice of slot	1) 10-10.20 (VIPs ONLY) 2) 10.25-10.45 (VIPs ONLY) 3) 11.15 - 11.35 4) 11.40 - 12.00 5) 12.05 - 12.25 6) 12.30 - 1.00 (30mins slot) 7) 2.00 - 2.20 8) 2.25 - 2.45 9) 2.50 - 3.10 10) 3.40 - 4.00 11) 4.05 - 4.25 12) 4.30 - 5.00 (30mins slot) 13) 5.25 - 5.45 14) 5.50 - 6.10 15) 6.15 - 6.35 16) 7.20 - 7.40 17) 7.45 - 8.05
Preferred SECOND choice of slot	1) 10-10.20 (VIPs ONLY) 2) 10.25-10.45 (VIPs ONLY) 3) 11.15 - 11.35 4) 11.40 - 12.00 5) 12.05 - 12.25 6) 12.30 - 1.00 (30mins slot) 7) 2.00 - 2.20 8) 2.25 - 2.45 9) 2.50 - 3.10 10) 3.40 - 4.00 11) 4.05 - 4.25 12) 4.30 - 5.00 (30mins slot) 13) 5.25 - 5.45 14) 5.50 - 6.10 15) 6.15 - 6.35 16) 7.20 - 7.40 17) 7.45 - 8.05
Preferred THIRD choice of slot	1) 10-10.20 (VIPs ONLY) 2) 10.25-10.45 (VIPs ONLY) 3) 11.15 - 11.35 4) 11.40 - 12.00 5) 12.05 - 12.25 6) 12.30 - 1.00 (30mins slot) 7) 2.00 - 2.20 8) 2.25 - 2.45 9) 2.50 - 3.10 10) 3.40 - 4.00 11) 4.05 - 4.25 12) 4.30 - 5.00 (30mins slot) 13) 5.25 - 5.45 14) 5.50 - 6.10 15) 6.15 - 6.35 16) 7.20 - 7.40 17) 7.45 - 8.05
Total amount you have ALREADY paid
Payment made via	iBanking ATM Transfer
iBanking Nic or ATM transfer date/time
If I transferred via ATM Transfer,I will send the Transaction Receipt after submitting this form.	YES
Bank Account details(in case of refund)
Other Comments/Questions
Should we have to put you in your second or third preferred slot, you and your friends will be placed together. We will not separate all the names gathered in a form. Please note, you and your friends WILL be notified of your confirmed slot number via SMS. We will send you a confirmation SMS within 24 hours via WHATSAPP or SMS. Victoria Jomo will not be responsible/entertain receipts that you have destroyed or misplaced or accidentally lost. If you are unable to produce a receipt, Victoria Jomo has the right not to accept your order. Please make sure the ATM Machine is capable of producing the receipt.