Name *

First

Last

Quantity *

• 1 Bracelet -₦8,000
• 2 Bracelets -₦15,000
• 3 Bracelets -₦22,000
• 4 Bracelets -₦28,000

Bracelet Color *

• Black
• Pink
• Blue

(Bracelet colors if more than one)

Bracelet type *

• For Android
• For ios (Iphone)

Phone Number *

Alt Phone Number

Delivery Address *

State & LGA of delivery *

Phone Type/Name/Model *

Email

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