ON-LINE OFFER
REQUEST FORM

To request for an offer of VEPLUS, please fill out the information below.

For orders to be shipped to an international address, we will generate a quote for shipping to your specific destination.

Mailing information:

E-Mail Address:
Name:
Company:
Street Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:
Fax:

Offer requested:

I would like to receive an offer of the following quantity of VEPLUS:
 

TYPE OF CASES

Nš OF CASES

x 420 bottles of the liquid

TYPE OF CASES

Nš OF CASES

x 504 bottles of the liquid

TYPE OF CASES

Nš OF CASES

x 6 display stands of bottles

TYPE OF CASES

Nš OF CASES

x 600 microfiber cloths

TYPE OF CASES

Nš OF CASES

x 24 display stands of cloths



Shipping method:
Please tick one of the boxes below:

Air Freight to, Airport:
Sea Freight to, Port:
Road transport

Your activity sector:

Optician/Optical Chain... Nšof Stores:
Optical Buying Group . . . Nšof Members:
Wholesales-Importer . . . Nš of Customers:
Others . . . Please, specify:

When all the information has been entered, select the submit button to send your request.

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