The Sunglass Connection Order Form

The Sunglass Connection, P.O. Box 163, Fayetteville, GA 30214, USA

Important: When you have filled out the form to your satisfaction, click on the SEND button at the very bottom of the form to enter your order. If you have the Netscape browser, version 1.22 or later and the key at the bottom is broken, you can encrypt your order for the latest in privacy and credit card security.

UPS will not deliver to a P.O. box. Please list a street address for shipment.

Order Information:

Premier Collection $29.95 each

- Quantity
- Subtotal Item 2

Classic Collection $24.95 each

- Quantity
- Subtotal Item 4

- Subtotal Above Sunglasses
- GA Residents Please Add 5% Tax
- Shipping and Handling (See Chart Below)
- Grand Total (U.S. Funds Only)

           Shipping & Handling Chart
           -------------------------
                        First Pair   Each Add'l Add
   Continental U.S.:
     UPS Select          $ 4.95          $0.75
     Overnight           $17.50          $1.50
     2nd Day             $11.50          $1.00

   Canada:               $ 9.95          $1.00

   Other International   $35.00          $3.00
   Deliveries:

Bill to:

- Name
- Street Address (UPS cannot deliver to PO boxes)
- City
- State/Province
- ZIP/Postal Code
- Country
- Daytime Phone
- E-Mail Address

Credit Card Account:
Discover American Express Visa Mastercard

- Credit Card #
- Name on card
- Expiration Date

Send To (if different from Bill To):
- Name
- Street Address (UPS cannot deliver to PO boxes)
- City
- State/Province
- ZIP/Postal Code
- Country
- Daytime Phone

- (select to send order) - (select to clear the form)