73 Glen Road
Hilton
Bloemfontein
9301
Box 64483
Bloemfontein
9300
Phone: +27 51 447 7549
Fax: +27 51 447 3736
customr@mweb.co.za
Name
Surname
Email (*Required)
Telephone
(Code) Number
Fax
(Code) Number
Would you like a quote?
Yes
No
If yes, would you like it :
e-mailed
or faxed
Personal Measurements:
1. Total length
2. Inside length forearm
3. Length hand
4. Width hand
5. Chest circumference
6. Eye-shoulder distance
7. Arm length
Shape of face
Slender
Rounded
Dominant side
Right handed
Left handed
Comment/Suggestions: