Print it out, fill it out and mail/fax it in ... no information is sent over the internet.
Make checks payable to: Your Safety Store
Mail to: Your Safety Store; P.O. Box 128; Hiawatha, IA 52233
or FAX with Credit Card Info to 319-378-1311
Any questions, phone toll 1-800-373-2873 ext. 0- For Customer Service
| Name: | |||
| Address: | |||
| City, State, ZIP: | |||
| Phone (if we have any questions): | |||
| Circle Credit Card Type: | VISA |
MC |
American Express |
| Credit Card # | Exp. Date | ||
| Signature: | |||
| Qty | Item# | Description | Unit Price | Total | Qty. | Item # | Description | Unit Price | Total | |
| PE5M | 2 oz Cop-Top - splatter stream | $6.99
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PE11MF | 4 oz Cop-Top - fogger | $7.99
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| PE5M-FT | 2 oz Flip-Top - splatter stream | $6.99 |
PE11MF-FT | 4 oz Flip-Top - fogger | $7.99
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| PE5MF | 2 oz Cop-Top - fogger | $6.99
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PE11PF | 4 oz Cop-Top - pepper foam | $7.99
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| PE5MF-FT | 2 oz Flip-Top - fogger | $6.99 |
PE11PF-FT | 4 oz Flip-Top - pepper foam | $7.99
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| PE5PF | 2 oz Cop-Top - pepper foam | $6.99
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PE12M | 4 oz Cop-Top w/holster - splatter stream | $9.99
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| PE5PF-FT | 2 oz Flip-Top - pepper foam | $6.99 |
PE12MF | 4 oz Cop-Top w/holster - fogger | $9.99
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| PE6M | 2 oz Cop-Top w/holster - splatter stream | $8.99 |
PE12PF | 4 oz Cop-Top w/holster - pepper foam | $9.99
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| PE6MF | 2 oz Cop-Top w/holster - fogger | $8.99
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PE14 | 9 oz Firemaster | $17.99
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| PE6PF | 2 oz Cop-Top w/holster - pepper foam | $8.99
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PE15 | 9 oz FM w/holster | $22.99
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| PE11M | 4 oz Cop Top - splatter stream | $7.99
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PE16 | 1 lb Firemaster | $19.99
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| PE11M-FT | 4 oz Flip-Top - splatter stream | $7.99
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PE17 | 1 lb FM w/holster | $24.99
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| TOTAL | |
| Sales Tax 5% (Iowa Residents Only) | |
| Shipping & Handling* | |
| GRAND TOTAL |
* Shipping and handling charges are as follows for the continental United States:
$0 to 49.99…………………………………………………………………$5.50
$50 to 99.99……………………………………………………………….$8.50
$100 to 149.99…………………………………………………………..$12.50
$150 to 199.99…………………………………………………………..$16.50
$200 to 299.99…………………………………………………………..$20.50
$300 to 399.99…………………………………………………………..$24.50
$400 to 499.99…………………………………………………………..$28.50
Over $500………………………………………….Free Shipping & Handling
Overnight, 2 nd day or any shipping method other than ground will be calculated upon request.
Please contact us for orders to be shipped outside of the continental United States.
Click here if you would like to also order law enforcement pepper spray.
Click here if you would like to also order personal civilian pepper spray.
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