tag:blogger.com,1999:blog-42205184772739582792024-02-08T05:30:45.659-08:00Best Bun In KUALA LUMPURAnonymoushttp://www.blogger.com/profile/07441704680726710424noreply@blogger.comBlogger1125tag:blogger.com,1999:blog-4220518477273958279.post-46493702021351792142012-04-13T20:25:00.004-07:002013-09-02T23:01:19.288-07:00BORANG TEMPAHAN<!-- Begin Response-O-Matic Form -->
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<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>NAMA :</strong>
</td>
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<input type="text" name="name" id="name" size="40" value="" />
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<td valign="top">
<strong>NO.KAD PENGENALAN :</strong>
</td>
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<input type="text" name="field-23ec5ef74c6e171" id="field-23ec5ef74c6e171" size="40" value="" />
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<strong>ALAMAT :</strong>
</td>
<td valign="top">
<input type="text" name="field-4f85b1b0f901a4a" id="field-4f85b1b0f901a4a" size="40" value="" />
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<tr>
<td valign="top">
<strong>NO.TEL :</strong>
</td>
<td valign="top">
<input type="text" name="field-af583006fdc1182" id="field-af583006fdc1182" size="40" value="" />
</td>
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<strong>EMAIL :</strong>
</td>
<td valign="top">
<input type="text" name="email" id="email" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>JENIS BUNGKUSAN :</strong>
</td>
<td valign="top">
<select name="field-b30837810a0e80b" id="field-b30837810a0e80b">
<option value="6 BIJI 1 PEK">6 BIJI 1 PEK</option>
<option value="2 BIJI 1 PEK">2 BIJI 1 PEK</option>
<option value="1 BIJI 1 PEK">1 BIJI 1 PEK</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>JENIS ROTI</strong>
</td>
<td valign="top">
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_0" value="CHICKEN FLOSS" /> CHICKEN FLOSS<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_1" value="APPLE PIE" /> APPLE PIE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_2" value="BLUEBERRY" /> BLUEBERRY<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_3" value="BLUEBERRY CHEESE" /> BLUEBERRY CHEESE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_4" value="BUTTER" /> BUTTER<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_5" value="CHOCOLATE" /> CHOCOLATE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_6" value="CHOCOLATE BUTTER" /> CHOCOLATE BUTTER<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_7" value="CHOCOLATE CHEESE" /> CHOCOLATE CHEESE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_8" value="CHEESE" /> CHEESE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_9" value="COCONUT" /> COCONUT<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_10" value="DURIAN" /> DURIAN<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_11" value="GARLIC BUTTER" /> GARLIC BUTTER<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_12" value="COCONUT" /> COCONUT<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_13" value="KAYA" /> KAYA<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_14" value="BUTTER KAYA" /> BUTTER KAYA<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_15" value="PINEAPPLE" /> PINEAPPLE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_16" value="RED BEAN" /> RED BEAN<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_17" value="CUSTARD" /> CUSTARD<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_18" value="PEANUT BUTTER" /> PEANUT BUTTER<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_19" value="STRAWBERRY" /> STRAWBERRY<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_20" value="STRAWBERRY CHOCOLATE" /> STRAWBERRY CHOCOLATE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_21" value="SARDINE" /> SARDINE<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_22" value="SAMBAL BILIS" /> SAMBAL BILIS<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_23" value="SPECIAL MIX" /> SPECIAL MIX<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_24" value="TUNA" /> TUNA<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_25" value="MIX" /> MIX<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_26" value="BUTTER MIX" /> BUTTER MIX<br/>
<input type="checkbox" name="field-3ecff6daebf57c1[]" id="field-3ecff6daebf57c1_27" value="NEW MIX" /> NEW MIX<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>KUANTITI:</strong>
</td>
<td valign="top">
<input type="text" name="field-85306faa036d1df" id="field-85306faa036d1df" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>TARIKH DIPERLUKAN</strong>
</td>
<td valign="top">
<input type="text" name="field-87e30892794d153" id="field-87e30892794d153" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>JENIS PEMBAYARAN :</strong>
</td>
<td valign="top">
<select name="field-f3f0339eb0d6226" id="field-f3f0339eb0d6226">
<option value="TUNAI">TUNAI</option>
<option value="CASH DEPOSIT">CASH DEPOSIT</option>
<option value="CEK">CEK</option>
</select>
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p>Untuk pelanggan yang menggunakan CASH DEPOSIT berikut adalah butiran tentang cara pembayaran :</p>
<p>No.Akaun CIMB : Rokiah Binti Samsudin (</p>
<p>Setelah membuat pembayaran, lampirkan resit pembuktian pembayaran anda kepada :-</p>
<p>E-mail : aizatjaya@yahoo.com</p>
<p>atau</p>
<p>WhatsApp : 0194201924</p></strong>
</td>
</tr><tr>
<td valign="top">
<strong>ANDA PERLU MEMBUAT PEMBAYARAN DEPOSIT SEBANYAK 50% SEMASA MEMBUAT TEMPAHAN DAN SELEBIHNYA KETIKA ANDA MENERIMA TEMPAHAN. DUIT BAYARAN DEPOSIT TIDAK AKAN DIPULANGKAN SEMULA SEKIRANYA ANDA MEMBATALKAN TEMPAHAN PADA 3 HARI SEBELUM TARIKH TEMPAHAN DIPERLUKAN.</strong>
</td>
<td valign="top">
<select name="field-69c76fb59b92d72" id="field-69c76fb59b92d72">
<option value="SETUJU">SETUJU</option>
<option value="TIDAK SETUJU">TIDAK SETUJU</option>
</select>
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<td colspan="2" align="center">
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