Sports Vision Online Order Form

Address

First Name	Last Name	M. Int.

Address 1

Address 2

City
State
Province / Country

Zip

Telephone


International Tel

Email Address

Payment information VISA|MC|DISC|Other


Expiration date.
/
MM             YYYY

Shipping Method

Standard shipping is 2 day US Priority Mail - $5.25.

Note prices are as stated on product pages. We will confirm total price with you by email or phone before processing your card.

Order Specifications

Frame & Lenses or Lenses Only

Lens Color

Lens Material

Frame to order

Frame size

Frame Color

Own Frame Size

Rx Lens type

	+ or -	SPH	+ or -	CYL		AXIS
OD					x
OS					x

PD (Pupilary Distance):

OD ADD + (Bifocals only)

OS ADD + (Bifocals only)

Before ordering, we recommend that you call or email us to review the best frame and lens options for your specific needs. Please submit one form for each order.