Online Submission

To participate, please fill up the form below with your details.

* Required

 

Name *

 

Mobile Number *

 

Email *

 

Receipt Number *

Click here to view receipt samples

 

Amount Spent *

Please indicate amount spent on the receipt provided

 

Receipt Image *

 

I confirm that the information submitted is true and accurate. In the event the information submitted is found to be fraudulent, erroneous and/or incomplete in any way, I acknowledge that my participation in the Promotion may be rejected or deemed void at the Company’s sole discretion.*

 

I acknowledge that I have read and understood the Terms & Conditions, and consent to the collection, use and disclosure of my personal data by Dutch Lady Pte Ltd. for the purposes set out therein.