Thursday, December 23, 2010

Order Form

**Some of the lens either have a number or name. Please include
EITHER or BOTH of them in the order form below**

The order form below is only for ORDERING purposes ONLY.
If you have any questions, please email us at: bigboldeyes@yahoo.com
( If I dont reply within 48 hrs, please resend! )

Before ordering, please read :






Contact/Order Form

First Name *


( This name will be sent to your shipping address)

Last Name *



Email *



Confirm Email *


Subject *


(what you are ordering - ex: Contact lens)

Address *




Street Address



Address Line 2



City


State / Province / Region



Postal / Zip Code


Country

Payment Method *

 Paypal 
 Concealed cash 

Paypal Email



Order(s) *


(QUANTITY IN PAIRS) Name of lens (Lens #) : R: # / L:#

ex: (1) Nudy Blue (CH-622) : R: -1.25 / L: -1.00

Refer:

 Yes, I would like to make a refer name 
If your friends send me an email with your referred name once you hit 6 refers get a pair of GEO for free!

Refer Name:



Who am I referring:


Full this out only if you're referring a friend :)


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