Please attach your
prescription to this form and fax or mail it to us. Delivery is generally 7-10 business days,
plus 5 for coating, although special Rx’s could take a little longer. Super rush orders have an extra charge of
$35. No refund or cancellation allowed after payment. Any problem glasses can
be credited to re-done prescription.
Prescriptions will be
filled in antishatter polycarbonate except insert
glasses (outer glasses are already polycarbonate) which must be in optical
plastic to avoid distortion. Upon
request, we are able to supply your prescription in Z87 industrial safety
thickness – at no extra charge.
PRESCRIPTION MUST
INCLUDE PD (PUPILLARY DISTANCE). If PD is not on your prescription, simply
contact whoever gave you glasses at any time and ask for your PD.
Single vision
prescriptions are priced as follows and include Rx sunglasses in custom cases:
ALL MODELS: Clear Tint Polarized Photochromic
(Day & Night)
$99 $149 $229 $229
EXTRA TREATMENT (To add to above
prices), CIRCLE ITEMS WANTED
Progressive (NO-LINE) $125 ALIZE
Anti-Reflect, Anti-Scratch $79
Flattop Bi-focal (D28 Segment) $50
Anti-Sweat, Hydrophobic Coating
TD-2 Anti-Scratch Coating $39
Transitions SUPERDARK Tinting $35
Mirror Coating $59 Surcharge for Sun Pro Models $25
(Silver, Gold, Blue, Red)
Surcharge for Powers Above 3.50
$35
Anti-Reflective Coating $40
High Index for Very High Powers
$50
(Ideal for Night, Dusk, and
(Super Thin)
High Glare Conditions)
Rimless Models
$50
2 PAIR – DIFFERENT Rx–10%
OFF EACH. SAME Rx WITH COATINGS - 50% OFF 2ND PAIR.
SHIPPING: UPS Ground:$9.50 UPS 2nd Day Air:$17.50 UPS Next Day Air:$35.00___
Name:
________________________________
Address: _____________________________
Phone: (619)794-2358
______________________________________ Fax: (619)236-1436
Specify Kahaney
Unit 701
Phone: ____________ Cell:
____________ E-Mail:usasportsd@aol.com
Web
Site:www.usa-sport.com
Fax: _________________________________
E-Mail: ______________________________
ORDER DETAILS
Sunglass Frame Lens Extra
Model Color Color Treatment Amount
________________________________________________________ ________
________________________________________________________ ________
Shipping ________
Total ________
Check ___ Money Order ___
Mastercard
___ Visa ___ Discover ___ American Express ___
Number
________________________________ Exp. Date _____________