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Repair Mail-in Form
» Print this form and fill it out .
» Securely wrap your glasses and enclose this form.
» Be sure to include all parts
» Be sure to include your return address on the outside of the package.
» If you are unable to print this form, please ensure that you send us your contact details with your glasses, including daytime telephone number.
| Name: |
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| Address: |
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| Post Code: |
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| Daytime Phone Number: |
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| Evening Phone Number: |
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| Email: |
…………………………………………………@………………………………………………………… |
| Comments: |
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We are pleased to accept all major credit cards
  
All information obtained from the use of credit cards will be held in the absolute strictest of confidence!
All credit card information is destroyed, by shredding, 30 days after invoice date for your protection.
Credit Card fraud is a crime. Violators will be prosecuted to the fullest extent of the law.
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