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RESERVATION FORM FOR NATURAL VEGAN AMPOULES

Collection validity period is based on coupon purchased. Reserve at least 24hours in advance for self-pick up. Please quote your unique reservation code number provided after submission of this form and produce your NRIC for verification for self collection.

Delivery via local SingPost service within 5 to 10 working days. Free normal delivery service available. For registered SingPost service, vist this link for payment. of $3 per box. Delivery overseas is available at $5 per box to Asia countries and $7 to rest of the world.

Exclusive one-time Ultrasonic Facial or Body Slimming treatment is valid until 30 Jun 12 and subjected to availability. You may pick up ampoules on the same or different day of the facial appointment. Click here to find out more about the $9.90, $12 and $29 options available.

IMPORTANT: If you have problems submitting the reservation here or have any other enquires, simply send the required information to sales@kelynesther.com.

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* Required information.
NAME *
MOBILE NO: *
EMAIL: *
NO OF BOXES *
AMPOULE TYPE *
F1. Anti-Irritant
F2. Anti-Blemish
F3. Anti-Pigmentation
F5.Anti-Wrinkles
F5. Revitalizing Fresh
F6. Firming Collagen
F7. Soothing Hydro
F8. Revitalizing Oxygen
F9. Brightening AHA
F10. Illuminating Eye
B1: Thermic Slim
B2: Cool Anti-Cellulite
DELIVERY OPTIONS: * You are strongly encouraged to pick up item at shop which is centrally located in Bugis (Opposite Illuma Shopping Centre). For postage, Kelyn Esther is not responsible for lost mail, wrong postage address or breakage (low probability) during postage.

To speed up authentication of your coupon, please attach your pdf/jpeg coupon. If you have problems with the attachments, please key in the voucher codes and/or keys manually.

DEAL SITE * Please select the deal/coupon site name which you purchased your coupon from.
ATTACH PDF VOUCHER PLEASE ATTACH YOUR PDF VOUCHER.
ENTER VOUCHER CODE/KEY MANUALLY Please enter 1 voucher code on each row. For coupons with key, please key both coupon code and key.

Fill in this section only if you select self-pick up. To enjoy the facial promo, you may have it on the same or different day as your ampoules collection.

SELF PICK-UP (ONLY) DATE: Please ensure that the collection date is at least 1 working day after the form is submitted
PREFERED FACIAL/SERVICE DATE (Confirmation via SMS) Please note that all facial/service appointments are subjected to availability. A confirmation SMS will be sent to you within 1-2 working days to confirm the appointment. Alternatively, you may call/sms 9889 9449 for faster response.
PREFERRED FACIAL/SERVICE TIME (Confirmation via SMS) Please indicate your preferred facial/service data and time which are subjected to availability. Our staff contact you within 1 to 2 working days via SMS to confirm the appointment. Alternatively, your may call/sms 9889 9449 for faster booking of appointments.

Fill in this section only if you selected normal or registered SingPost delivery. Please pay your postage using the link at the top of the form.

DELIVERY ADDRESS
PAID $3 PER BOX FOR REGISTERED SINGPOST DELIVERY? If you have not, please visit our weblink below to pay $3 per box and provide your address. Please provide the order number after completing the payment.http://www.kelynesther.com/welcome/coupon/delivery.html
KELYN ESTHER ORDER NO FOR PAID POSTAGE After completing your delivery payment of $3 per box via our shopping cart, you will receive an order number with your paymetn deals. please enter the order number here

IMPORTANT: Please check your form before clicking the sent button. A confirmation email with your submitted details will be sent to your email address. For self-pick up, please quote your reservation number and produce your NRIC for verification.

REMARKS OR ANY SPECIAL INSTRUCTIONS?
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