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Semelia Order Form

Pricing

Paypal Payment $60.00 Sale Price $40.00
Payfast, Ukash Voucher, credit and debit card R525.00 Sale Price R425.00
South Africa, Direct Deposit and EFT R500.00 Sale Price R400.00

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Full Name
Contact Number 1
Contact Number 2
E-mail Address
Alt e-mail address
Physical address
Area code
Postal address
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