Harris Communications Order Form

Please mail or fax order forms to
Harris Communications
15155 Technology Drive
Eden Prairie, MN 55344

Fax: 952-906-1099

IMPORTANT: Orders will not be processed unless prepaid by check, credit card or money order.

NOTE: Orders that are mailed or faxed to Harris Communications using this order form are not considered Internet orders. Items promoted as Internet-only purchases that are ordered with this form will be charged regular retail price.

ORDERED BY / BILL TO
Customer #
(found at top of mailing label on back of catalog)
Address
Apt/Ste
City
State / Zip
Phone	V TTY VP
Email

SHIP TO
Same as BILL TO
No P.O Boxes
Address
Apt/Ste
City
State / Zip
Phone	V TTY VP
Email

GIFT CARD MESSAGE (optional)

Please include a Harris Communications catalog.
Yes No

SHIPPING CHART

Order total	Add	Order total	Add
Up to $25.00	$6.50	$500.01-$1000.00	$17.00
$25.01-$50.00	$7.00	$1000.01-$2000.00	$20.00
$50.01-$100.00	$8.00	$2000.01-$3000.00	$30.00
$100.01-$200.00	$10.00	$3000.01-$4000.00	$40.00
$200.01-$300.00	$12.50	$4000.01-$5000.00	$50.00
$300.01-$500.00	$15.00	$5000.01 and up	Call
Shipments to AK, HI, PR, Canada or international destinations, please call for quote.

PRODUCTS
QTY	ITEM NO	ITEM	COLOR/SIZE/ETC	GIFT WRAP $4.95/ea	UNIT $	TOTAL




MN orders: add 7.275% sales tax to SUBTOTAL + SHIPPING. WI orders: add 5.6% sales tax to SUBTOTAL + SHIPPING.				SUBTOTAL
				SHIPPING
			TAX (MN & WI residents add sales tax)
				TOTAL

PAYMENT METHOD
Check or money order is enclosed (payable to "Harris Communications") Visa MasterCard Discover Card American Express
Credit Card Number	CVV2*	Exp. Date
* CVV2 is the card security code of 3 or 4 numbers after the credit card number, often found on the signature panel.
Signature - (required)