First name

Last name

Country

Town / City

District

Phone

Email address

Order notes (optional)

Product	Subtotal
Hisense 32'' LED TV - Black × 1	UShs 365,000
Changhong 32″, LED backlight TV × 1	UShs 650,000
Sayona Air Cooler with Remote \| SAC-2420 × 1	UShs 395,000
SPJ 24000 BTU Air Conditioner \| ACSWTS-24KCO008 × 1	UShs 2,680,000
Subtotal	UShs 4,090,000
Shipment	Delivery to Kampala: UShs 5,000
Total	UShs 4,095,000