HARMONY CONCEPTS, INC. Box 310 North Hollywood CA 91601 USA
TELEPHONE ORDERS TO (818)755-1025 • FAX ORDERS TO (818)755-1024
email us at: sales@harmonyconcepts.com
Order Form
Use this form to order by surface mail using personal check or
money order.
We will not pick up mail that requires our signature.
Click here to download this form. Adobe Reader Required
to view and print.
Handling and Packaging Costs: U.S. DVD orders are post
paid.
*Overseas buyers requesting Global Priority (some countries excluded) add $11.00 for
up to 5 DVD's
Total Payment of $____________________________________ is enclosed.
Charge my: _____ Visa _____MasterCard
Account #: _________________________________________________________
Expiration Date: _____________________________________________________
Signature: __________________________________________________________
Print Cardholder's Name: ______________________________________________
Customer ID Number will appear above your name on the label of your first
order. This number is not necessary for first time orders.
Name:______________________________________
Street Address: _____________________________________________________
City: ___________________________ State: _____________ Zip: ____________
Country: __________________________
Order
Please send the following items. (Use Harmony code, i.e. JE-12, or SDS-55, PN-6,
etc.
__________ $ _____________ __________ $ _____________
__________ $ _____________
__________ $ _____________
__________ $ _____________
__________ $ _____________
__________ $ _____________
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THE VAULT MEMBERSHIP $19.95 + 15.95 per month. (Email address required)
Please print your Email address on the line below:
_________________________________________________________________________________
California 8.25% Tax: $_____________
Postage and Handling: $_____________(No
Shipping charge for DOMESTIC DVD orders.)
Total of Order: $_____________