TOLL FREE1-866-856-9050
Wiley X Eyewear
Andrew's Military Supply Inc.
1956 Souvenir Drive
Clearwater, FL 33755
Fax: 727-449-8687 - Tel: 866-856-9050 (Toll Free)
PRESCRIPTION ORDER FORM
REVISED: April, 2004
Single Vision Only!
NO BI-FOCAL PRESCRIPTIONS ACCEPTED.
*The prescription lenses in your Wiley X are made of polycarbonate material. Polycarbonate is the safest most impact resistant prescription lens
available. It will be fabricated to exacting standards, and while not a Z87.1 safety lens, it will meet and exceed the drop-ball testing standard for
such a lens. Dealers in the state of New Jersey should especially take note of this.

Andrew's Military Supply
Refund Policy
Shipping Policy
Customer Service
Privacy Policy
Rx Prescripton
(Rx Must include Pupil Distance)
PRESCRIPTIONS NOT ACCEPTED WITHOUT PUPIL DISTANCE
Wiley X sunglasses will accept –3 to +2 sphere & -2 to +2 cylinder.  The 50, 100, 480, P-17 & SG-1 will accept –3 to +3 sphere & -2 to
+2 cylinder.  The
JP-3, P-23, P-38 & P-44 will accept -2 to +2 sphere & -2 to +2 cylinder.  The JP-2 will accept –3.5 to +3.5 sphere & -2
to +2 cylinder.  The
Xl-1 will accept 0 to –3 sphere  & 0 to –2 cylinder
FRAME MODEL TO FILL WITH PRESCRIPTION
*PLEASE NOTE THAT THE SG-1 IS THE ONLY INTERCHANGABLE STYLE, ONCE RX’D
* A model must be selected if no frame is being sent in.  If ordering SG-1 lenses only, select the SG-1 lens cylinders box.
* Lens cylinders are per set of prescription lenses. For example, if you order 2 sets of prescription lenses, you will need two sets of lens cylinders.
*When prescription lenses are made for any of the glasses(except the SG-1), they are no longer interchangeable-the lab has to glue the lenses in when they
prescript them. These glasses will not come with the additional lenses that would ordinarily come with the non-prescription package.
*The only interchangeable style that remains so after installing prescription lenses is the SG-1.However the prescription cost is per set of lenses. For example, if
you order the frame and check the Grey box for prescription lenses, you will receive the frame, a set of Grey prescription lenses, and a set of Clear non-
prescription lenses. If you want the Clear lenses prescript as well, it would cost an additional $100.00 and you will need to check the Clear box on the order form.
Prescription Cost (SINGLE VISION ONLY; ANTI-FOG COATING NOT AVAILABLE)
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PAYMENT METHOD
All prescription sales are final. Be sure to try the
frame on before ordering.
Should a warranty
inspection become necessary, you must first call
Wiley X for a return authorization # at: 866-856-9050.