Wizard Devices Fax Order Form

WEB-CONTACT FAX ORDER FORM

PRINT, FILL OUT, THEN FAX TO 301-309-6825!

ITEM #	DESCRIPTION	Indicate SIZE/COLOR desired	COST	QUANTITY	TOTAL
	Breacher	Dark Grey	274.95
	DSL Demolition Safety Light	Yellow or Dark Grey	59.95
	DIGI-GAL	Yellow	399.95
	Photon Microlight with Keychain	Yellow or Red	10.00
	Photon Microlight with Lanyard	Yellow or Red	12.00
	Photon Microlight II with Keychain	Yellow or Red	16.00
	Photon Microlight II with Lanyard	Yellow or Red	18.00
	Photon Microlight II with Keychain	White, Blue, or Green	22.00
	Photon Microlight II with Lanyard	White, Blue, or Green	24.00
	CR-2032 3 Volt Eveready Lithium (only for red,yellow, and green; each light requires one battery)	n/a	2.50
	CR-2016 3 Volt Eveready Lithium (only for white and blue; each light requires two batteries)	n/a	3.00
	Wizard 50	n/a	324.95
	Special Effects Fogging Compound	n/a	34.95
	Klunker Box Light Sequencer	n/a	1,799.95
	Battery Supply	n/a	449.95
	Disintegrating Bridge Wire - each	n/a	1.50
	AG-1 Flash Bulbs - 1 dozen	n/a	9.00
	M-3 Flash Bulbs - 1 dozen	n/a	25.00
	Bomb Pin/Tie Tack	Sterling Silver	19.95
	Pyrotech T-Shirt	Large or X-Large Black or Ash	19.95
	Special FX T-Shirt	Large or X-Large Black or Ash	21.95
	Wizard Devices Pin	Multi-Color	3.95
	Wizard Devices Hat	Black	14.95
	Wizard Devices T-Shirt	Large or X-Large Black or Grey	19.95
	Wizard Walker - walking stick	Wizard, Elephant, Raven, Claw with Skull	149.95

Maryland residents add 5% Sales Tax to your order.

$____________

The cost of my order, less shipping (provided at time of order/confirmation), is:

$_____________

SENT BY:

Name: _____________________________________

Address: ___________________________________

City, ST Zip: ________________________________

Phone: _____________________________________

Card #: ____________________________________

NOTE: Your name, address, phone number, or credit card will NOT be sold, given out, or sent over the internet. Your order and means of payment will be verified by a call from Wizard Devices to the phone number you provide.

SEND TO:

WIZARD DEVICES, Inc.
7731 Tuckerman Lane #186
Potomac, MD 20854
FAX: 301-309-6825
email: wizard1@erols.com

VISA, MasterCard, American Express, & Discover cards are accepted. Thank you for your business. Wizard Devices is committed to your satisfaction and safety.

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