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Whatsapp Order Form
Please Complete this whatsapp Order Form to place your order?
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Email
*
Your email
Confirm Email address
Your answer
Payment Date
*
Your answer
Contact Cell number
*
Your answer
Name & Surname
*
Your answer
Your FULL Delivery Address:
*
Your answer
FULL Order (Please be very specific)
*
Your answer
Delivery Option (add Delivery Cost to your product Cost) NO Cash on Delivery
*
Choose
Pudo Locker Collection R99 (1-4 working days) Collect at your nearest Mall or Petrol Garage
Door to Door Courier R110 (2-4 working days) Delivered to your doorstep at home or work address
International Shipping R399 (Outside of SA borders) 5 -39 working days
Other
Payment Method (NO Cash on Delivery)
*
Choose
Payment Link sent via Whatsapp to pay with Visa/Mastercard
FNB ATM CASH Deposit (Open 24 Hours) A/C 6 2789 709 494 National Male Clinic
FNB A/C 6 2789 709 494 Internet Transfer National Male Clinic
FNB Ewallet 081 448 0600
Capitec A/C 136 350 6283 Internet Transfer SHP / Cvd Merwe
Capitec 081 448 0600 Cellphone to Cellphone
Option 7
Money Transfer 0814480600 PEP/Shoprite/Checkers/PicknPay/SPAR
ABSA Cash Send 081 448 0600
Standard Bank Instant Money 081 448 0600
Nedbank Send-Imali 081 448 0600
Option 12
Makuru Money Transfer
Option 14
Actual Amount you are paying over = Total
*
Your answer
Please send proof of PAYMENT to us on whatsapp? Please make sure all your order details are correct on this 1 (ONE) order form, as we can not be liable if you supply us with incorrect or incomplete forms. Do you understand & Accept all T&C's on '
www.nationalmaleclinic.co.za
Accept?
*
Yes
Required
Click on SEND MESSAGE now. Wait for this form to pull through to our WhatsApp chat to place your order. IF YOU HAVE ANY ISSUES WITH THIS FORM PLEASE NOTIFY US ON WHATSAPP 081 448 0600 to assist you?
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