Product Order Form
To Order by Phone, Please Call Toll-Free 1-888-672-5437 or 612-672-5437. To order, simply print out this page, fill it out, and mail to: National Institute on Media and the Family, 606 24th Ave. So., Suite 606, Minneapolis, MN 55454. Or fax to: 612-672-4113
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Ordered By: Name (please print)________________________________________________ |
Ship To: (if different than ordered by) Name (please print) ________________________________________________ |
ITEM # |
PRODUCT NAME |
QUANTITY (x) |
PRICE (=) |
TOTAL |
Subtotal: |
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MN Sales Tax* |
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Optional Donation** |
$5.00 |
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Shipping & Handling*** |
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TOTAL: |
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* MN Sales Tax: Orders shipped within Minneapolis city limits, please include 7% sales tax. Orders shipped within Minnesota, please include 6.5% sales tax. Method of Payment
Purchase Order Number (if applicable):________________________________ Bill my credit card: Visa Number: ________________________________________ Your Signature:_______________________________ Tax Exempt ID Number (if applicable):____________________________ |
** Help Make an Impact! Add a $5.00 donation to your total and help us continue distributing our information and materials across the country. Call 888-672-5437 for quantity discounts. ***Shipping and Handling Charges Order Subtotal Charge $ 1.00 - $ 10.00 =
$5.00 Prices and items are subject to change and availability. |
Check or Money Order payable to National Institute on Media and the Family