By placing with, and/or accepting from, Dawntreader Pyrotechnic Specialties, any order you certify that:

1ST TIME BUYERS: YOU MUST SUBMIT A WRITTEN ORDER ON THIS FORM, SIGNED-IN-INK, ACKNOWLEDGING AND ACCEPTING THE ABOVE CONDITIONS, BY MAIL ALONG WITH A PHOTOCOPY OF YOUR DRIVER'S LICENSE. PGI members send photocopy of membership card to get 5% professional courtesy discount.

Signed:_____________________________ in agreement with the above rules and meeting the outlined requirements

Date:__________________________ SHIPPING INFO:

NAME: _________________ STREET:_____________________ CITY:_______________

STATE:______ ZIP: _________ PHONE: _(___)___________

EMAIL:______________________

Please print, fill, sign, and send to:

Dawntreader Pyrotechnic Specialties
3074 Earnett Street
Memphis, TN 38128-4913


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