eyeTrust Equipment Order Form

Thank you for your interest in eyeTrust products, please fill out the form below.

Full Name

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E-mail

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Phone Number

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Shipping Address

Include city and postal code

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Item Number(s)

If ordering more than one product, please separate each product with a comma (ex. ET12, ET8)

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Quantity

If ordering more than one product, please put "Item Number" and "Quantity" beside it (ex. ET121). Separate each product with a comma (ex. ET121, ET81)

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Payment method?

Cheque
Cash
Bank E-Transfer

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I accept Terms & Conditions (http://eyetrust.ca/terms-and-conditions)

To view "Terms and Conditions", copy link above into a new window or tab.

I accept

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