|
|
| |
Lens Order Form - CR39 Uncoated
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Please print and complete this form before faxing it to +44 (0)20 8871 2482 |
| |
|
|
|
| From: .................................................................................................... |
|
Pairs: [ ] |
Pieces: [ ] |
| |
| Date: ........................................ |
|
|
|
Back Order: Yes [ ] No [ ] |
|
| |
| |
| GROUP 2 |
|
GROUP 2/2 (-SPH/ +CYL) |
|
GROUP 2/2 (+SPH/ +CYL) |
| SPH |
+ |
- |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
| 0.00 |
|
|
|
-0.00 |
|
|
|
|
|
|
|
|
|
+0.00 |
|
|
|
|
|
|
|
|
| 0.25 |
|
|
|
-0.25 |
|
|
|
|
|
|
|
|
|
+0.25 |
|
|
|
|
|
|
|
|
| 0.50 |
|
|
|
-0.50 |
|
|
|
|
|
|
|
|
|
+0.50 |
|
|
|
|
|
|
|
|
| 0.75 |
|
|
|
-0.75 |
|
|
|
|
|
|
|
|
|
+0.75 |
|
|
|
|
|
|
|
|
| 1.00 |
|
|
|
-1.00 |
|
|
|
|
|
|
|
|
|
+1.00 |
|
|
|
|
|
|
|
|
| 1.25 |
|
|
|
-1.25 |
|
|
|
|
|
|
|
|
|
+1.25 |
|
|
|
|
|
|
|
|
| 1.50 |
|
|
|
-1.50 |
|
|
|
|
|
|
|
|
|
+1.50 |
|
|
|
|
|
|
|
|
| 1.75 |
|
|
|
-1.75 |
|
|
|
|
|
|
|
|
|
+1.75 |
|
|
|
|
|
|
|
|
| 2.00 |
|
|
|
-2.00 |
|
|
|
|
|
|
|
|
|
+2.00 |
|
|
|
|
|
|
|
|
| |
| GROUP 4 |
|
GROUP 4/2 (-SPH/ +CYL) |
|
GROUP 4/2 (+SPH/ +CYL) |
| SPH |
+ |
- |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
| 2.25 |
|
|
|
-2.25 |
|
|
|
|
|
|
|
|
|
+2.25 |
|
|
|
|
|
|
|
|
| 2.50 |
|
|
|
-2.50 |
|
|
|
|
|
|
|
|
|
+2.50 |
|
|
|
|
|
|
|
|
| 2.75 |
|
|
|
-2.75 |
|
|
|
|
|
|
|
|
|
+2.75 |
|
|
|
|
|
|
|
|
| 3.00 |
|
|
|
-3.00 |
|
|
|
|
|
|
|
|
|
+3.00 |
|
|
|
|
|
|
|
|
| 3.25 |
|
|
|
-3.25 |
|
|
|
|
|
|
|
|
|
+3.25 |
|
|
|
|
|
|
|
|
| 3.50 |
|
|
|
-3.50 |
|
|
|
|
|
|
|
|
|
+3.50 |
|
|
|
|
|
|
|
|
| 3.75 |
|
|
|
-3.75 |
|
|
|
|
|
|
|
|
|
+3.75 |
|
|
|
|
|
|
|
|
| 4.00 |
|
|
|
-4.00 |
|
|
|
|
|
|
|
|
|
+4.00 |
|
|
|
|
|
|
|
|
| |
| GROUP 6 |
|
GROUP 6/2 (-SPH/ +CYL) |
|
GROUP 6/2 (+SPH/ +CYL) |
| SPH |
+ |
- |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
|
SPH |
0.25 |
0.50 |
0.75 |
1.00 |
1.25 |
1.50 |
1.75 |
2.00 |
| 4.25 |
|
|
|
-4.25 |
|
|
|
|
|
|
|
|
|
+4.25 |
|
|
|
|
|
|
|
|
| 4.50 |
|
|
|
-4.50 |
|
|
|
|
|
|
|
|
|
+4.50 |
|
|
|
|
|
|
|
|
| 4.75 |
|
|
|
-4.75 |
|
|
|
|
|
|
|
|
|
+4.75 |
|
|
|
|
|
|
|
| 5.00 |
|
|
|
-5.00 |
|
|
|
|
|
|
|
|
|
+5.00 |
|
|
|
|
|
|
| 5.25 |
|
|
|
-5.25 |
|
|
|
|
|
|
|
|
|
+5.25 |
|
|
|
|
|
| 5.50 |
|
|
|
-5.50 |
|
|
|
|
|
|
|
|
|
+5.50 |
|
|
|
|
| 5.75 |
|
|
|
-5.75 |
|
|
|
|
|
|
|
|
|
+5.75 |
|
|
|
| 6.00 |
|
|
|
-6.00 |
|
|
|
|
|
|
|
|
|
+6.00 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
