Order Form

Invoice Request

Full Name

Company

Address

Street Address

Address Line 2

City

State / Province / Region

Postal / Zip Code

Country

Email

Phone Number

### - ### - ####

Order Number

Items Ordered/ lens list including power

Include quantity next to item seperated by a comma. (i.e. item, 1)

Comments and Questions

♥postage method♥

register: $5.99usd/ RM21.19 will take 15 days   EMS: $41.28ush will take 3-5days   POST EXPRESS Free Shipping to Malaysia (Only for 1-5pairs)   Rm6 fast mail to Malaysia

♥payment method♥

Paypal   Conceal Cash

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