| Home | Requisition Form |
Our Products
How to order

Please fill in the Requisition Form below to notify your interest. On the Code area type the code of each item that your interest, and use separator coma ( , ) if you type more than one code.
For more information please contact us:
jokebali@telkom.net
info@baliprima.com

* * *
 
Requisition Form


Type of Company Trading agents    
  Wholesaler    
  Retailers    
  Dept. Store    
Company Name*    
Contact Name*    
Mailing Address    
Telephone    
Facsimile    
E-mail*    
       
Product of Interest :      
  Batik Fabrics Sarongs / Scarves  
  Code : Code :  
   
  | |  
  Sandal / Bags    
  Code    
     
  |    
     
       

 

 

© Copyright 2004
by Bali Prima