PT.

BIO CYCLE INDO

RPH Bubulak Jl KH Abdullah Bin Nuh, Bogor Barat 16115

BSF EGGS ORDER FORM

Thank you for the order. Please kindly fill in this form and email it back to :
2268775390@qq。com。 We will then return your reply with a Proforma Invoice on the
payment amount.
Indicate name of recipient NOT company name : Essam Abdulhamid

Indicate contact number of recipient : +201069415764

Indicate Order Amount :

Please indicate “x” in the appropriate Box.
Price 80 cent USD per gram (not inclusive of Courier charges)
For first time Evaluation
10 ........ grams
1,000 grams

Indicate Country Destination : Egypt

Indicate Delivery Address : 1 Abo Soliman St., Ouseem, Giza, Egypt

Indicate Postal Code :

Indicate Payment Method :

Please indicate “x” in the appropriate Box.

WU Payment by Western Union Payment by Pay Pal

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