LENZ Curbside Order Form

Here we go!
We need some information to fulfill your order.
Information we absolutely need is marked with a red asterisk.
If you have not already read the instructions on the LenzArts.com home page, go do that first!

Your Contact Information

First Name

Last Name

Email Address

Phone number

Alternate Phone Number

Credit/Debit Card Billing Address

We only want your card address; we’ll call you for the actual card number at the time of your purchase.

Street Address/PO Box

State

City

ZIP Code

The Goodies!

Just do your best. We don’t require you to know exactly what you need. If you have a budget, feel free to include that since that will guide us.

Items would you like to purchase and comments to Lenz staff:

Please know we have a $20 minimum for orders due to the extra labor involved with curbside service.

If you want, upload an image file if you think it’ll help (jpg,gif,pdf).

If you need to send more than one image, tell us in the comments and we’ll get back to you for the rest.

How did you hear about our curbside service?

We will contact you with any questions and once your order is ready to go we’ll call you for payment by credit/debit card.

Thank you!

Order Test

LENZ Curbside Order Form

Your Contact Information

Credit/Debit Card Billing Address

The Goodies!