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APPLICATION FORM PLEASE PRINT CLEARLY
1. (street address Singapore) ____________________________
2. Name to accept mail in: _____________________
3. Code word or Number for future instructions ______________________________________
4. Name to forward mail to you: (Please note. One personal name & one Company name is acceptable in most cases. See each country as we may be able to arrange mail in unlimited names). _________________________________________________________________
Use "Singapore Street Address" as your ordering code.
To pay by Bank wire, BitCoin, Moneybookers/Skrill, MoneyGram or Western Union please proceed to and order at our secure web site order form at https://www.ptshamrock.com/order_bwe.html Your order code is "Asia Street Address."
To order and pay by CREDIT or DEBIT CARD:
Email for credit card payment details
Thank you for your business.