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ORDER FORM


To place your order, fill out the form below and hit the "Place Order" button. We will contact you to arrange payment. If you have any questions, please contact customer service via email at johnny@leelenses.com
Shipping Information: 
Full Name:
Email Address (required):
Phone Number (required):
Address:
City: State: Zip:

Product # of Pairs Price
Subtotal:
Shipping (10%):
Tax:
Total:

When finished, hit the place order button to submit your order.


Email: johnny@leelenses.com

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