SALAMade-to-Order Form Name * First Name Last Name Email * Mobile Number * (###) ### #### Instagram @ Address SKIP :) Address 1 Address 2 City State/Province Zip/Postal Code Country To be filled up by a Pranca representative: Order * Total Amount * Include shipping costs if necessary Php Fulfillment * Pickup at JMA Jewelry Metro Manila Delivery (Php 200.00) Provincial Delivery (Php 250.00) Payment Method Bank Transfer/Deposit Credit Card Kindly wait for a notification once your order is ready for pickup/delivery. Thank you!