First name

Last name

Country

Town / City

District

Phone

Email address

Order notes (optional)

Product	Subtotal
IQRA 16" Stand Fan,50W copper motor,5 blades (IQ-SF708) - Black × 1	UShs 170,000
Matrix 2 in 1 Powerful Blender \| MP1200 × 1	UShs 87,000
ADH 8kg Washing Machine – Silver × 1	UShs 650,000
Subtotal	UShs 907,000
Shipment	Delivery to Kampala: UShs 5,000
Total	UShs 912,000