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 $7.00 $1000.01-$1500.00 $22.00
$25.01-$50.00 $8.00 $1500.01-$2000.00 $27.00
$50.01-$100.00 $9.00 $2000.01-$3000.00 $30.00
$100.01-$200.00 $11.00 $3000.01-$4000.00 $40.00
$200.01-$300.00 $13.00 $4000.01-$5000.00 $50.00
$300.01-$500.00 $16.00 $5000.01 and up Call
$500.01-$1000.00 $18.00

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.   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)