TASER® Weapon Order Form

For information on the new C2 TASER® please call 1-800-352-5294 to place your order.

Name
Address
City State
Zip Phone
Credit Card
Exp. Date
Drivers License
Exp. Date


Drivers License:_______________________ Convicted of a felony?___

Additional items:______________________________________


FREE Shipping for all Tasers. Other items ship for $4.55 each.


Total Charge including shipping:$__________

Print and fax to: 702-341-1652 or mail with payment to:
Internet Company, 8628 Canyon View Drive, Las Vegas, NV 89117-5820

If you cannot print this form, please use the printable form.