QRpho Order Form QRpho Order Form Organization Name Website http://www.yourwebsite.com Name * First Name, M.I., Last Name Email * Phone No./Cellphone No. No. of Employees/Students Type of Subscription * QRpho Level 1 (1-25 employees) at P5,995.00/year QRpho Level 2 (26-50 employees) at P11,495.00/year QRpho Level 3 (51-75 employees) at P16,795.00/year QRpho Level 4 (76-100 employees) at P22,195.00/year Above 100 employees Order QR Code IDs? Yes No We will send you a separate email for the ID order processing. Mode of Payment * Paypal Bank Deposit Western Union Palawan Pawnshop | Cebuana Lhuillier | LBC Send Me the Bill, will process Check payment for deposit to your bank account Message/Instructions * We will be sending you the payment instructions after we received your order. Please wait for our email before proceeding for payment. Captcha
