Manual Order Form

★ Manual Order Form
Please fill out this form if you are interested in joining this pre-order.
and kindly send all orders to email: isabelline@live.com

Pre-order/ Ready stock??
☆ Full Name :
☆ Email :
☆ Phone Number :
☆ Address :
☆ Contact Lens Types & Code :
☆ Quantity ( Pair ) :
☆ Power ( Left. If any ) :
☆ Power ( Right. If any ) :
☆ Message ( if any ) :