Order Form


Kindly follow this Order Format and send it to: amberlightz@hotmail.com


Thanks a million:)

Name:
Hp No:
Bank Acc no:(In case of refunds!)
Address: (if you're choosing postage of item!)




1) Lens Code:
Colour:
Degree(L/R):Quantity:

Alternate(In case out of stock)

Lens Code:
Colour:
Degree(L/R):

2) Lens Code:
Colour:
Degree(L/R):Quantity:

Alternate(In case out of stock)
Lens Code:
Colour:
Degree(L/R):


Total Quantity:
Total Amt: $