HARMONY CONCEPT, INC. BOX 7264 VAN NUYS, CA 91409
PHONE ORDERS TO: 818-988-9672, FAX ORDERS TO: 818-988-9607

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: __________________________
Phone:______________________________
                                          Order
Please send the following items. (Use Harmony code, i.e. JE-12, or SDS-55, PN-6, etc.
__________ $ _____________       __________ $ _____________     __________ $ _____________
__________ $ _____________       __________ $ _____________     __________ $ _____________   
__________ $ _____________       __________ $ _____________     __________ $ _____________   
__________ $ _____________       __________ $ _____________     __________ $ _____________   
__________ $ _____________       __________ $ _____________     __________ $ _____________

THE VAULT MEMBERSHIP $19.95 + 15.95 per month. (Email address required)
Please print your Email address on the line below:
_________________________________________________________________________________

California 9.75% Tax:   $_____________


Postage and Handling:   $_____________(No Shipping charge for DOMESTIC DVD orders.)


Total of Order:         $_____________