Order Form

Kindly complete the form below to place an order with Dax’s Ducks.

One product per form. For multiple product orders, submit another form and select the product. Only your Name will be required for the subsequent forms.

Upang makabili ng mga produkto mula sa Dax’s Ducks, Mangyaring kumpletuhin ang sumusunod na form.

Tandaan: Isang produkto lamang ang maaaring bilhin sa bawat isang form. Kung nais bumili ng higit sa isa, magsumite ng panibagong form sa bawat isang karagdagang produkto.

Tanging pangalan lamang ang kailangang ilagay sa mga susunod pang forms.

Name

First Name

Last Name

Products

All products are subject to availability.

Number of Ducks

Kindly indicate number of plants below

Contact Number

Please provide a working contact number for order confirmation.

Email Address

Delivery Address