****We only accept checks, money orders and mail in credit card information on purchases of $100.0 and up****
Use this form if you want to mail in your order by check or money order. All checks MUST clear through the
bank before product will be shipped.  
Click Here to go back to main page or to order online.


    DATE:_______________________



    Name: __________________________                         Name:_______________________________

    Ship To Address:_________________________         Billing Address:________________________
                                
_________________________________________      _____________________________________

_________________________________________      _____________________________________

_________________________________________       _____________________________________

_________________________________________       _____________________________________

     

Email Address:____________________________

Phone Number:____________________________   
MUST HAVE A TELEPHONE NUMBER


    QUANTITY        MODEL NUMBER AND DESCRIPTION               UNIT PRICE               AMOUNT

    ________         ___________________________________          _________                _______

    ________         ___________________________________          _________                _______

    ________         ___________________________________          _________                _______

    ________         ___________________________________          _________                _______

    ________         ___________________________________          _________                _______

    ________         ___________________________________          _________                _______  


    SUBTOTAL  _______  

                                                  FLORIDA RESIDENTS MUST INCLUDE SALES TAX (7.0%)   _______

THERE IS A $7.95 SHIPPING & HANDLING CHARGE FOR ORDERS LESS THAN $50.00        _______

             TOTAL DUE=________
 


    Name on Credit Card__________________________             Check, Money Order, or Credit Card.

    Credit Card Type_____________________________   (VISA, Master Card, Discover, American Express)

    CC#___________________________CCV _______             

    Expiration Date______________________________            

    Signature___________________________________

    Make all checks payable to: Self Defense Products Florida/Theresa Troolines

    THANK YOU FOR YOUR BUSINESS!


    It is the buyers responsibility, not the seller, to ascertain and obey all applicable local, state, and federal laws regarding the
    possession and use of any item offered by Self Defense Products Florida. If you are unsure, please contact your local or state
    authorities. By placing an order, the buyer represents that all products purchased will be used in a lawful manner and that he/she
    is of legal age.