Order Form
Mega Gas - Lim Poh Wah
Fill in your details below to place your order.
Full Name:*
Email:*
Contact Number:*
Postal Code:*
Street:*
Building Name (if applicable):
Unit Number (if applicable, e.g. #08-168):
Are you an existing Esso LPG user?*
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Yes
No
Quantity:*
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-- Select your option --
1
2
Size of Cylinder:*
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-- Select your option --
9kg
11.3kg
12.7kg
14kg
Not sure
Date*
Preferred Delivery Time:*
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8AM - 10AM
10AM - 12PM
12PM - 2PM
2PM - 4PM
4PM - 6PM
6PM - 8PM
Preferred Mode of Contact:*
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Email
Phone
I accept the
Terms and conditions
.
I want to be informed about future promotions.
Confirm
For more information, please call our authorised distributor – Mega Gas / Lim Poh Wah at 6899 3388.