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PURPLE WAVE - IN STOCK ONLINE ORDER FORM
How to Fill This Form:
Date: Pick today’s or your preferred delivery date.
Name & Address: Write your full name and complete delivery address.
Phone Number: Active number for confirmation.
Social ID (Optional): Your Facebook/Instagram ID if you ordered through social media.
Product Details: Write product name, quantity & price.
Delivery Charge: Select based on your area.
Order Note (Optional): Add any special instructions.
Total Price: Product price + delivery = total payable to the delivery person.
Double-check before submitting!
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📅 Order Date
*
Choose Your Order Date.
👤 Your Name
*
Enter Your Full Name.
🏠 Your Address
*
Please Provide Your Complete Delivery Address.
📞 Your Mobile Number
*
Enter An Active Mobile Number (E.G 017XXXXXXXX)
📸 Facebook/Instagram ID
*
Enter Your Facebook or Instagram Username or Profile Link.
🛍️ Product Name [1]
*
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [1]
*
Enter How Many Units You Want To Order.
💰 Price [1]
*
Enter Product [1] Total Price.
🛍️ Product Name [2]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [2]
Enter How Many Units You Want To Order.
💰 Price [2]
Enter Product [2] Total Price.
🛍️ Product Name [3]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [3]
Enter How Many Units You Want To Order.
💰 Price [3]
Enter Product [3] Total Price.
🛍️ Product Name [4]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [4]
Enter How Many Units You Want To Order.
💰 Price [4]
Enter Product [4] Total Price.
🛍️ Product Name [5]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [5]
Enter How Many Units You Want To Order.
💰 Price [5]
Enter Product [5] Total Price.
🛍️ Product Name [6]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [6]
Enter How Many Units You Want To Order.
💰 Price [6]
Enter Product [6] Total Price.
🛍️ Product Name [7]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [7]
Enter How Many Units You Want To Order.
💰 Price [7]
Enter Product [7] Total Price.
🛍️ Product Name [8]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [8]
Enter How Many Units You Want To Order.
💰 Price [8]
Enter Product [8] Total Price.
🛍️ Product Name [9]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [9]
Enter How Many Units You Want To Order.
💰 Price [9]
Enter Product [9] Total Price.
🛍️ Product Name [10]
Enter The Full Name Or Product Code As Shown On Our Website.
🔢 Quantity [10]
Enter How Many Units You Want To Order.
💰 Price [10]
Enter Product [10] Total Price.
🚚 Delivery Charge.
*
Inside Dhaka - Tk 60.00
Suburbs - Tk 100.00
Outside Dhaka - Tk 120.00
Please Select Your Delivery Area. Charges Will Vary Depending on Your Location.
💸 Total Amount [Cash On Delivery]
*
Tk 0.00
Pay This Total To The Delivery Rider When You Receive Your Parcel.
📝 Order Note
Write Anything Extra You'd Like Us To Know.
Submit
