Applied Laser Order Form

If you don't see what you're looking for, just e-mail or call us with the product description. If you would rather place your order by fax or phone, refer to the non-virtual ways of getting in touch with us at the bottom of this page.

First Name: 
Last Name: 

Billing & Shipping Address (We can only ship to the billing address of your credit card)
Street Address (Line 1): 
Street Address (Line 2): 
City: State: 
Zip Code: 

Fax Number:
Email Address: Required

How did you locate our Web Site?

Fill out the order form as best you can following the format from line 1. If we have any questions, we will get back to you within (2) business days. Please include weapon make and model# so we can send you the correct mounting hardware.

$4.95 DOMESTIC, INTERNATIONAL* Call or Email for shipping options

*INTERNATIONAL ORDERS: ALL payments from outside the USA need to be by wire transfer bank to bank. Please email for details. Or you may fax us a copy of your drivers license, credit card and a signed note authorizing the sale. Please check your country laws. Buyer also agrees to obey all import laws concerning our Products and to hold Applied Laser blameless for legal problems associated to importing our products into your country. Applied Laser agrees to ship in good faith and to produce proof of shipment, but cannot return any moneys due to theft, loss or hold by customs or other government institutions.
California Residents please add 9.00% sales tax
Please enter total dollar amount and credit card information
Visa, Mastercard, Discover, American Express
Please include shipping charges with your order

Please select credit card:

Card Number: Expiration Date: 
Did you remember to include your weapon's model number and color?
Please enter any comments here
Please only press the "Order Now!" button once and aggree to send via email. It will automatically submit your order. We will email your order confirmation. You will not see an order confirmation screen. By pressing this button, you are agreeing to purchase the products listed above from Applied Laser, as this is considered to be a legal document. If you experience problems sending this page, please try the secure order form. If you do not hear from us within (2) working days, Please call us at (626) 795-5853. You may alternatively print and fax this order form to (626) 795-1815. We will email your order confirmation. Thank You
Please read our Terms and Conditions: Click Here

Applied Laser
2245 E. Colorado Blvd, Suite 104-120
Pasadena, CA 91107
Phone: 1-626-795-5853
Fax: 1-949-734-1775
New Toll Free Order Line
M-F 6AM-3:30 PM Pacific Time (800) 833-4780
E-MAIL to: Applied Laser

Gov't CAGE Code: 1C4C9

1995-2013 Applied Laser. All rights reserved.