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赫而司pchome團
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* Indicates required question
PTT ID (請寫正確，填錯者恕不收單)
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Your answer
真實姓名
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Your answer
pchome ID
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Your answer
手機號碼 (EX:0955-123123)
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Your answer
A-婦淨康益生菌 X5倍升級 (每單位100顆，$10/顆)
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Other:
B-蔓越莓可蘭莓 (每單位100顆，$8/顆)
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C-金巧軟膠囊DHA藻油 (每單位100顆，$10/顆)
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D-養顏葡萄籽複方植物膠囊 (每單位100顆，$10/顆)
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E-賽絡美得Ceramide+白藜蘆醇膠原錠($13/顆，每單位50顆，650元)
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F-日本Hi-Q10二代超微粒軟膠囊($15/顆，每單位50顆，750元)
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G-活顏素HA-100保濕膠原玻尿酸($24/顆，每單位50顆，1200元)
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Other:
H-加購防潮分裝小空罐(含乾燥劑1包)，每罐$20
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總金額(+雜費$5)
Your answer
是否同意合購內容(請再一次檢查各填寫項目)
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是
否
備註(補充說明事項請告知)
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