Mail and Fax Orders

To place a fax order, print out this form and fax to: 941-925-2088.

To place a mail order, print out this form and mail to:
E.W. Services
8851 Bloomfield Blvd.
Sarasota, FL 34238

*If NOT paying by credit card, please include your check or money order made payable to E.W. Services.

Your Order: (Indicate Sunglass Style, Lens Color and Quantity. Please print clearly.)
1.
2.
3.
Total:
Credit Card
Full Name on Card:
Card Number:
CVV2 Security Number:	Expiration Date:
Card Type: Visa MasterCard American Express Discover
Signature:
Billing Address for Credit Card
Name:
Street:	City:
Zip Code:	Country: US
Daytime Phone:	Evening Phone:
Shipping Address (Leave blank if same as billing address.)
Name:
Street:	City:
Zip Code:	Country: US
Daytime Phone:	Evening Phone: