Attachable or Complete including cleaning cloth and case with every pair, just $79.00 plus $5.00 shipping and handling in USA, Canada and Mexico or $9.00 for international shipping and handling. (Note: All amounts are in US dollars.)
Please allow 2-3 weeks for delivery by U.S. Postal Service.
Please print out this order form, fill out and send along with tracing and ordering page by mail.
If you are not completely satisfied, return the Vision Enhancers in original condition within 30 days for refund (less shipping and handling).

NAME:  _______________________________________________________
		(First)           (MI)          (Last)

ADDRESS:  ____________________________________________________

CITY:  _____________________  STATE:  ________  ZIP:  ________

COUNTRY:  ___________________  DATE OF BIRTH:  _______________
					   
TELEPHONE:  ___________________________ SEX __________________

E-MAIL:  ______________________________

Method of Payment (US Funds Only) (Circle One):
 
   Visa   MasterCard   Discover   American Express   Money Order   Check
If paying by check or money order, orders will be shipped once funds have cleared. Make checks or money orders payable to Vision Enhancers.

CREDIT CARD NUMBER:  _________________________________________

EXPIRATION DATE:  ____________________________________________

NAME ON CARD:  _______________________________________________

SIGNATURE:  __________________________________________________

Please remember to send your information and tracing on the Ordering Page along with this billing information page by mail.