Fill the following with valid information: Addres s: #333 high street 1) Enter Customer Title sanFer nando Mr.☐ Ms.☐ Mrs.☐ 2) Enter Customer Name Click or tap here to enter text.
3) Enter Customer Address
Click or tap here to enter text.
4) Enter Customer Contact
Click or tap here to enter text.
5) Please choose your Service Required
Choose an item.
6) Enter the Date of Request
Click or tap to enter a date.
7) Enter your Date of Birth
Click or tap to enter a date.
8) Are you a New Customer or Existing Customer?
Choose an item.
9) Enter your payment
Cash ☐ Cheque☐ Credit Card☐ customer service request form.docx