Please fill out this form completely, and click on the “Submit” button. Upon receipt of your order, you will receive an order confirmation from us via e-mail. Should you have any questions regarding your order, please contact us via info@bonocchio.com or call us at (+31) (0) 70-3636 092.

Gender:

Mr. Mrs. Ms.

First name:

*

Surname:

*

Date of birth:

Address:

Telephone:

E-mail:

*

Amount of contact lenses:

*

Self pick-up or delivery:

Self pick-up Delivery

Remarks:

*

*For any purchase of contact lenses of €100,00 or more, the contact lenses can be sent to your address within the Netherlands without any delivery costs. The contact lenses will be delivered after they have been paid (the invoice of which will be sent to you together with the order confirmation).

 

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