Saturday, July 11, 2009
Order Form
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:
- Please Select -
Neo Emotion Tear Brown
Neo Emotion Tear Gray
Neo Emotion Star Blue
Neo Emotion Love Pink
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 Cuty Black
Neo Chagall Circle
Neo Ring Circle
Neo Crystal Black
Neo Dali Brown/ Sweet Chocolate
Neo Princess Eyes Camel Brown
Neo Princess Eyes Pearl Gray
Neo Glamour Gray
Neo Glamour Brown
Neo Glamour Blue
Neo Glamour Green
Neo Glamour Violet
Neo Extra Dali Gray
Neo Extra Dali Brown
Neo Extra Dali Blue
Neo Extra Dali Green
Neo Extra Dali Violet
Left Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Geo Color Lens:
- Please Select -
XCH-624 Super Nudy (Wonder Eye) brown
XCH-625 Super Nudy (Wonder Eye) gray
XCM214 Super Angel (Sweety Eye) brown
XCM215 Super Angel (Sweety Eye) gray
HC104 (0 power only)
HC105 (0 power only)
BS202 (0 power only)
CC304 (0 power only)
Geo Ash Wing
Geo Honey Wing
Geo Wing Violet (0 power only)
Geo Wing Blue (0 power only)
Geo Angel Blue
Geo Angel Brown
Geo Angel Gray
Geo Angel Green
Geo Angel Violet
Geo Fresh Brown
Geo Fresh Gray
Geo Nudy Blue
Geo Nudy Brown
Geo Nudy Gray
Geo Nudy Green (0 power only)
Geo Nudy Golden Blue (0 power only)
Geo Nudy Violet (0 power only)
Geo Tricolor Blue
Geo Tricolor Brown
Geo Tricolor Gray
Geo Tricolor Green
Geo Tricolor Violet
CM721 Magic 2 Tone Violet (clearance)
CH724 Fresh Brown (clearance)
CH725 Fresh Gray (clearance)
Jazz Brown BC102
Magic Circle Black CK 108 (clearance)
Magic Circle Black CK 109 (clearance)
Magic Circle Black CK 105
Magic Circle Black CK 107 (clearance)
Magic Circle Black CM 836/Angel Black (clearance)
Animation Lens CP-A1 (0 power only)
Animation Lens CP-A2 (0 power only)
Animation Lens CP-A3 (0 power only)
Animation Lens CP-A4 (0 power only)
Animation Lens CP-A5 (0 power only)
Animation Lens CP-A6 (0 power only)
Animation Lens CP-A7 (0 power only)
Animation Lens CP-S1 (0 power only)
Animation Lens CP-S3 (0 power only)
Animation Lens CP-K4 (0 power only)
Animation Lens CP-F1 (0 power only)
Animation Lens CP-F2 (0 power only)
Animation Lens CP-F3 (0 power only)
Animation Lens CP-F4 (0 power only)
Animation Lens CP-F5 (0 power only)
Piercing IM-703 (0 power only)
Piercing IM-705 (0 power only)
Piercing IM-707 (0 power only)
T-eye 731 (0 power only)
T-eye 732 (0 power only)
T-eye Melon (0 power only)
Tear Brown
Tear Gray
Left Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
EOS Color Lens:
- Please Select -
EOS Max Pure Blue
EOS Max Pure Brown
EOS Max Pure Gray
EOS Max Pure Green
EOS Max Pure Violet
EOS Max Misty Blue
EOS Max Misty Brown
EOS Max Misty Gray
EOS Max Misty Green
EOS Max Misty Violet
EOS Max Gold Black
Left Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Pink Color Lens:
- Please Select -
Super Nudy Pink
Max Pure Pink
Burn Pink (0 power Only)
Left Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
Right Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
Beaucon Color Lens:
- Please Select -
Beaucon Natural Blue
Beaucon Natural Brown
Beaucon Natural Gray
Beaucon Vibrant Match Blue
Beaucon Vibrant Match Brown
Beaucon Vibrant Match Gray
Beaucon Vibrant Match Green
Beaucon Vibrant Match Violet
Beaucon Shimmer Blue
Beaucon Shimmer Brown
Beaucon Shimmer Gray
Beaucon Shimmer Green
Beaucon Shimmer Violet
Beaucon Jewels Blue
Beaucon Jewels Brown
Beaucon Jewels Gray
Beaucon Jewels Green
Beaucon Jewels Pink
Beaucon Jewels Violet
Left Eye PWR:
0.00
-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
-5.50
-6.00
-6.50
-7.00
-7.50
-8.00
-8.50
-9.00
-9.50
-10.00
Right Eye PWR:
0.00
-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
-5.50
-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)
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
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