Saturday, July 11, 2009

Order Form

Posted by Charlene_luv at 1:13 AM
Dear customers, please completely fill out the order form below:

After submitting form, a paypal bill/banking details will be sent to your e-mail shortly. A notification e-mail will be sent to you if the lenses you ordered is OUT of stock.



Name:
Phone No:
Shipping Address:
Neo Color Lens:
Left Eye PWR:
Right Eye PWR:
Geo Color Lens:
Left Eye PWR:
Right Eye PWR:
EOS Color Lens:
Left Eye PWR:
Right Eye PWR:
Pink Color Lens:
Left Eye PWR:
Right Eye PWR:
Beaucon Color Lens:
Left Eye PWR:
Right Eye PWR:
For more than one item, please fill in your order here: 
(e.g. CK-105  -1.00/-1.00 x 1)
if you order "clearance sale" items, please write it here. 

Total Quantity Pair(s):
Email Address:
(PayPal)
Shipping: Standard Reg airmail (US$3.50/pair)(US$5.00 for 2-5 pairs)
Express Shipping (US$25)
Poslaju (Free within Malaysia)
Method of Payment: MayBank2U (Online Transaction)
Bank-in (Maybank)
Bank-in (Public Bank)
PayPal
Others
Referral Code:

Disclaimer
This disclaimer of liability applies to any discomfort or injury caused by contact lens wear.
IMPORTANT: Seek advice from eye-care practitioner to verify proper fit and follow the proper lens care guideline.
Follow the suggested wearing schedule which is not more than 6 hours per day to maintain your overall eye health.

I have read and understand the above statement and I accept full responsibility for my ongoing eye care and for the suitability of the contact lenses purchases.

For any inquiry, please contact us at: char_lens@live.com
 

Circle Lens ❤ Korea Geo, Eos, Beaucon Color Contact Lens Copyright 2010 Charleneshop