ICP Shop: Order Form CUSTOMER DETAILS Your Name*: ---Dr.Mr.Mrs.Ms.Prof. Your E-mail Address*: The staff may contact you in case there is a discrepancy in your payment and/or purchase. YOUR PURCHASE Class of 2019 Commemorative Shirts Shirt: ---Chemist Na Ako 2019ChemTech Na Ako 2019 Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Chemist Na Ako 2019ChemTech Na Ako 2019 Size: ---SMLXLXXL Quantity: 012345678910 Oath-Taking Shirts Shirt: ---Chemist Na AkoChemTech Na Ako Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Chemist Na AkoChemTech Na Ako Size: ---SMLXLXXL Quantity: 012345678910 Reactions Shirts Shirt: ---Reactions OMGReactions HEY BROReactions HEY SISReactions HEY BABEReactions I LV U Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Reactions OMGReactions HEY BROReactions HEY SISReactions HEY BABEReactions I LV U Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Reactions OMGReactions HEY BROReactions HEY SISReactions HEY BABEReactions I LV U Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Reactions OMGReactions HEY BROReactions HEY SISReactions HEY BABEReactions I LV U Size: ---SMLXLXXL Quantity: 012345678910 Shirt: ---Reactions OMGReactions HEY BROReactions HEY SISReactions HEY BABEReactions I LV U Size: ---SMLXLXXL Quantity: 012345678910 PAYMENT AND DELIVERY DETAILS Payment Method Used*: ---Bank Deposit (Cash)Online Transaction Upload your machine-validated deposit slip here*: JPG / PDF / PNG file only. Maximum size: 2 MB. Amount Paid (PHP)*: Amount as reflected on your deposit slip. Payment transaction code*: Payment Date*: Day: Month: ---JANFEBMARAPRMAYJUNJULAUGSEPOCTNOVDEC Year: Date of transaction as reflected on your deposit slip. Mode of acquiring the order*: ---Luzon / Metro Manila Delivery (+100 Pesos)Visayas / Mindanao Delivery (+150 Pesos)Pick up at ICP head office (FREE) Note: for delivery, the delivery fee must already be included in your payment. Delivery Address*: Please wait for a status prompt to appear below after clicking the ORDER button.