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文華餅房 訂購單

請完成以下表格填寫,填寫完畢請傳真至文華餅房 (02) 2715 6629 完成您的訂購

The Mandarin Cake Shop Order Form


Please complete this form and fax back to The Mandarin Cake Shop
at (02) 2715 6629 for your purchase.

文華餅房
The Mandarin Cake Shop TEL (02) 2715 6789

※ 此授權書請勿使用電子郵件回傳 DO NOT EMAIL THIS FORM ※

訂購品項 價格 數量 總計
Purchase Items Price Quantity Total

總計 Total

訂購人
Booker Name
聯絡電話 日間 夜間
Contact Number Daytime Evening
取貨日期
Pick-up Date

取貨方式
自取 Self Pick-Up 計程車配送 Taxi Delivery 宅配 Shipping
Delivery

配送地址
Delivery Address

二聯 Duplicate GUI
發票
Invoice 三聯 Triplicate GUI 統一編號 GUI NO:

付款方式 現金 Cash 匯款 Bank Transfer 信用卡 Credit Card


Payment ( 請填寫以下信用卡授權書 Please complete the credit card authorization form below )

請持卡人填寫以下欄位 CARDHOLDER - Please complete the following section and sign below

持卡人姓名 (正楷)
Cardholder Name (Please print)

信用卡類別
VISA AMEX MASTER DINERS JCB Others:
Credit Card Type

信用卡卡號 有效日期
Credit Card No. Expiration Date

本人同意支付上述款項, 消費金額 NT$


I agree to cover the above categories of charges up to a Maximum Amount of NT$

持卡人簽名(同信用卡上簽名) 日期
Cardholder Signature (as it Appears on Credit Card) Date

10548 台北市松山區敦化北路158號
158 DunHua North Road, Taipei 10548, Taiwan
http://www.mandarinoriental.com/taipei/

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