Sunday, October 19, 2008
Order Form
Dear customers, please completely fill out the order form below:
*Order will be processed and an invoice will be sent to you after receival of order form.
Name:
Phone No:
Shipping Address:
Neo Color Lens:
- Please Select -
Neo Sunflower Edge Aqua
Neo Sunflower Edge Blue
Neo Sunflower Edge Brown
Neo Sunflower Edge Gray
Neo Sunflower Edge Green
Neo Sunflower Edge Hazel
Neo Sunflower Edge Honey
Neo Sunflower Edge Violet
Neo Color Circle Blue
Neo Color Circle Brown
Neo Color Circle Green
Neo Color Circle Gray
Neo Color Circle Violet
Neo Black Circle/ Cuty Black
Neo Chagall Circle/ Cuty Charm
Neo Ring Circle/ Cuty Circle
Neo Carra Circle/ Crystal Black
Neo Dali Circle/ Sweet Chocolate
Left Eye PWR:
0.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Geo Color Lens:
- Please Select -
Geo Wing Violet
Geo Wing Blue
Geo Ash Wing
Geo Honey Wing
Geo Angel Blue
Geo Angel Brown
Geo Angel Gray
Geo Angel Green
Geo Angel Violet
Geo Fresh Brown
Geo Fresh Gray
Geo Magic Two Tone Blue
Geo Magic Two Tone Brown
Geo Magic Two Tone Gray
Geo Magic Two Tone Green
Geo Magic Two Tone Violet
Geo Nudy Blue
Geo Nudy Brown
Geo Nudy Gray
Geo Nudy Green
Geo Nudy Golden Blue
Geo Nudy Violet
Geo Tricolor Blue
Geo Tricolor Brown
Geo Tricolor Gray
Geo Tricolor Green
Geo Tricolor Violet
Geo Twins YH-301
Geo Twins YH-302
Geo Twins YH-303
Geo Twins YH-304
Geo Twins YH-305
Geo Twins YH-306
Magic Circle Black IM-108
Magic Circle Black CK 101
Magic Circle Black CK 105
Magic Circle Black CK 107
Magic Circle Black CM 836/Angel Black
Magic Circle Black Angel 101/Angel Define
Magic Circle JB 101/Jazz Brown
Magic Circle JB 102
Conventional Soft Lens Lux Pro
Conventional Soft Lens RX-3
Conventional Soft Lens RX-View
Animation Lens CP-A1
Animation Lens CP-A2
Animation Lens CP-A3
Animation Lens CP-A4
Animation Lens CP-A5
Animation Lens CP-A6
Animation Lens CP-A7
Animation Lens CP-S1
Animation Lens CP-S3
Animation Lens CP-K4
Animation Lens CP-F1
Animation Lens CP-F2
Animation Lens CP-F3
Animation Lens CP-F4
Animation Lens CP-F5
Piercing IM-703
Piercing IM-705
Piercing IM-707
T-eye 731
T-eye 732
T-eye Melon
Tear Brown
Tear Gray
Left Eye PWR:
0.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-0.25
-0.50
-0.75
-1.00
-1.25
-1.50
-1.75
-2.00
-2.25
-2.50
-2.75
-3.00
-3.25
-3.50
-3.75
-4.00
-4.25
-4.50
-4.75
-5.00
-5.25
-5.50
-5.75
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
For more than one item, please fill in your order here:
(e.g. CK-105 -1.00/-1.00 x 1)
Total Quantity Pair(s):
Email Address:
Method of Payment:
MayBank2U (Online Transaction)
Bank-in (Maybank)
Bank-in (Public Bank)
Cash on delivery
PayPal
Others
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
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