Autism Bracelets - I need help.® Communication Bracelets, Gluten-Free Diet Bracelets, Casein-Free Diet Bracelets, Epilepsy Bracelets, Diabetes Bracelet, Pacemaker Bracelet, Camp Bracelet, Custom Silicone Wristbands

I need help.® Communication Bracelets – Order Form

Use this form only if you want to pay with a check or to be invoiced. Use PayPal, shopping cart buttons, on bracelet home page, to pay with a credit card.

1) Fax, email or mail purchase orders from school districts/companies (please provide Tax ID No. and Certificate of Exemption (Form ST-3 when possible)) are accepted. Satina will invoice for payment. 2) Purchase Orders and/or order forms with checks and/or money orders written to Satina are accepted. 3) No cash sales.

Ship to:

_______________________________________________
_______________________________________________
_______________________________________________
______________________________________________
Phone: _________________________________________
Email: _________________________________________
Where did you hear about the I need help bracelets? ______________________________________________
Bracelets will be used by/for:_____________________

Bill to:

_______________________________________________
_______________________________________________
_______________________________________________
______________________________________________
Phone: _________________________________________
Email: __________________________________________
Exempt Sales: Please provide MN Tax ID number and Certificate of Exemption (Form ST-3): ____________________________
Check Number: ________________________

See Bracelet Catalog for Part Numbers and Price
Order Date: Check Number:
Bracelet Name	Bracelet Catalog Part Number	Bracelet Price	Youth Size Quantity		Adult Size Quantity	Total Bracelets Ordered	Subtotal Price	Total Price









Pre-Sub Total Price
Mail check and bracelet orders to: Satina I need help.® communication bracelets c/o Sherri Goehring, 9733 Kent Avenue Montgomery, MN 56069				US Shipping and Handling Fee -Add: 1 to 10 quantity add $3.80 11 to 25 quantity add $7.50 26 to 300 add $14.35 301 to 500 add $19.25 Note: Canada, Mexicao and all International orders see shipping rate listed below**
Sub-Total Price
Note: MN Exempt Sales that provide Tax ID No. and Certificate of Exemption (Form ST-3) does not add tax.				Minnesota Only Tax (MN residents only add 6.875% tax to sub-total) (To calculate MN Tax: 6.875 x Sub-Total = TAX)
TOTAL PRICE

**Canada and Mexico shipping fees: 1 to 10: $5.50, 11 to 25 $13.50, 26 to 300 $29.95, 301 to 500 $38.25

All other International shipping fees: 1 to 25 $15.50, 26 to 300 $45.95, 301 to 500 $59.25

Satina website: www.ineedhelpcommunicationbracelets.com Telephone 507-744-2027, Fax 507-744-5210, Email sherri@means.net