HARMS HISTORICAL PERCUSSION

91 NM Branch Road
New Marlborough, MA 01230 , USA
Phone (413) 229-7720; Fax (413) 229-2983

ORDER FORM

For your convenience, you can fill out the Order Request Form below. You can choose the most convenient method of ordering:

E-mail the completed form to Harms Historical Percussion by selecting "Submit Form" button at bottom. (Payment must be received before the order is shipped out).
Print the completed form from your browser and mail it together with check.
Print the completed form and fax the form to (413) 229-2983 (payment must be received before the order is shipped out).

Send any checks (US$ drawn on US Bank) to:
HARMS HISTORICAL PERCUSSION
* 91 NM Branch Road * New Marlborough, MA 01230 USA

Please provide the following contact information :
(All information is confidential and will not be sold or used by other organizations)

Name & Title

Organization

Street address

Address (cont.)

City

State/Province

Zip/Postal code

Country

Phone

FAX

E-mail

Please provide the following product information:

Qtty	Product Name (full description & comments)	Finish (if applicable)	Price per Unit	Total
		Light Dark Will you accept the other finish if your choice is not available?	$	$
		Light Dark Will you accept the other finish if your choice is not available?	$	$
		Light Dark Will you accept the other finish if your choice is not available?	$	$
Accessories: Instrument Case (if applicable)				$
Subtotal				$
Shipping				$
MA residents add 5% Tax				$
TOTAL				$

Submit payment by check in US$ drawn on a US Bank
For Purchase Orders (Net 30 Only), P.O. must accompany the order

Mail payments to:
Harms Historical Percussion
91 NM Branch Road
New Marlborough, MA 01230 USA