Mailing Label USPS, UPS or FedEx

WE ARE CURRENTLY UNABLE TO SHIP OR RECEIVE TO/FROM CANADA.

Order Form

Customer Information: ALL orders require a signed and completed Customer Information Sheet below.

We accept only VISA and MASTERCARD.  Please be sure to complete shipping address on the form below and note if billing address for the charge card and name are different.  Signature is required on all orders. Thank you.

Money orders and personal checks accepted

Shipping Information:

Name: ______________________________________

Address: ____________________________________

City:____________________State_____Zip________

Contact  Phone: ______________________________

Email: ______________________________________

Payment Method:

Check ____ Money Order ____ Credit Card Type______

Give Credit Card info here or call 1-866-FRAME-FX

Name on Credit Card: ___________________________

(Visa or MasterCard Only)

Card Number: ________________________________

Expiration Date: ______________________________

Billing Address if different:____________________________

City:____________________State: _______ Zip:_________

Signature: ______________________________________ PLEASE NOTE:  FRAMFIXERS takes every precaution to protect all plastic and metal eyeglass components during repair procedures, however, we can not be responsible for discoloration or abrasions that may occur to used parts.

Printable version of this form