WBAtbp Payment Form

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Name:
Email Address:
Contact Number:
Facebook Account Name:
Address:
Billing statement
Where did you pay?	BPI (preferred) BDO G-cash ML Kwarta Padala Cebuana Lhuillier LBC Palawan Express Western Union Cash
Branch:
Mode of Payment	Partial Payment Full payment with shipping cost
Amount Paid:
Date of payment:
Reference Number:

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