ORDER FORM

(Please complete this online order form to place your order.
You will receive confirmation and an invoice 24 hours when your order has been successfully processed.
(Kindly send us your order via email (manually) if you find this order form doesn't work)
Thank You.

Name:
Email Address:
Contacts No.:
Type of Item:	Contact Lens Clothes Beauty Health
Delivery Methods :	Pos Laju Pos Express Parcel
Item(Code/Quantity/Color/Power):
Address(Required) :
Are you agree with our Terms & Conditions(T&C)?	Yes, I agree with all Ellysha Shop terms & condition(T&C).