Wufoo

MinarinShop Order Form

Thank you for ordering via MinarinShop! Please fill out this form in its entirety. Please e-mail any questions or send me a message on the homepage.

Please check over your information (especially your shipping address) for accuracy before submitting this form!

IMPORTANT! Do not use this form to edit/cancel an order you have already placed. Please send me an e-mail to edit or cancel your order.

NOTE: Your information will never be used for anything else other than to place your order. I will not call the number you provide. This information is required simply because some vendors require this information before confirming an order. If preferred, leave a note in the Notes/Comments/Special Requests field asking that I provide my phone number for the order.

DISCLAIMER: By submitting this form, you agree that you have parental consent to make this order or that you are of the age of majority.

DO NOT USE THIS FORM FOR SECHUNA ORDERS.

Full name * First Last
Please enter your full name.
LiveJournal username (if applicable)

Please enter your LiveJournal username. If you do not have one, please enter n/a (not applicable).
E-mail address *

Please enter a valid e-mail address.
Shipping Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country

Please enter the address where the items should arrive.
Telephone number * - (###) - ### ####
Some stores require that a phone number be provided, so please fill out this section. If you wish that I provide my number for the order, please specify in Notes.
Item List *

Please specify the items you would like to have purchased, including the URL (if applicable).
Where are you ordering from? *
YesAsia J!NX Play-Asia J-XYZ PlaJapan eBay Livejournal user/shop (please specify in Notes) Other (please specify in Notes)

Please select which store you are ordering from.
Payment method *
Concealed cash Money order PayPal Other (please specify in Notes)

Please select the method of payment you are using. Take note that delivery times vary and there is the possibility of money being stolen or lost in the mail. Please take caution.
Shipping Method *
Cheapest Priority Express (most expensive) Other (please specify in Notes)

Please specify how you would like your items shipped to you. Please keep in mind that options, titles and delivery times vary from store to store and depend on where you live.
Notes/Comments/Special Requests

Please enter any other information or special requests required to process your order.
Do Not Fill This Out