1: PRODUCT / PACKAGE
a. Select Member or Gold

2: STANDARD ORDER
a. Choose 4 types of capsule
b. Delivery Frequency - Every 2 month
c. Next Delivery Date - Next month
d. Commencing Date - 4th, 14th or 24th

3: INITIAL ORDER
a. Choose 4 types of capsule
b. Delivery Mode - Delivery
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4. CUSTOMER INFORMATION
a. Contact No.: 65xxxxxxxx

5. DECLARATION
a. Customer's Signature

6. SALES PARTNER INFORMATION
a. Auto-filled, do not edit.
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7. PAY NOW
a. Visa or Master card