Bill to:
Name _____________________________________
Address _____________________________________
City, State, Zip _____________________________________
Daytime Phone _____________________________________
Evening Phone _____________________________________

HELIX
FAX/ORDER FORM

in Illinois: 312/421-6000
outside Illinois: 800-33-HELIX
fax: 312-421-1586
email: info@helixcamera.com
Payment:
Money Order
Certified Check
Personal/Business Check
Please make checks or money orders payable to Helix. Note that we use Tele Check to verify all checks. All forms of payment must be drawn on U.S. banks
 
Visa
Mastercard
Discover
American Express
International orders - We only accept wire transfer for payment
Ship To:
Name _____________________________________
Address _____________________________________
City, State, Zip _____________________________________
Orders by telephone, fax, or e-mail can be paid for by credit card. Make sure that your card information is filled in correctly.

Orders by mail can be paid for by credit card, money order, certified check, personal check, or business check.
Name as it appears
on the card 		______________________________________
Card Number _________ _________ _________ _________
Expiration Date _________ CVV Code _ _ _
CVV Code = 3 digits in signature strip on back of card to the right of the (partial) card number. Signature ______________________________________
Your Order:
Quantity Product # Description Unit Price Amount
         
         
         
         
         
SHIPPING CHARGE
We ship UPS ground unless otherwise specified. Use the chart to determine shipping, handling & insurance fee. For UPS air, UPS to rural Alaska, Parcel Post, truck freight, overseas shipments or orders over $1000, please contact us for the correct charge. There will be a $5.00 documentation fee added to all foreign shipments
   
Subtotal
Illinois residents add 9 % tax
Shipping, Handling & Receiving
TOTAL
Order Total
IL, IN, IA, KY, MI,
MN, MO, OH, WI
AZ, CA, ID,
NV, OR, WA
All other states not shown
AK, HI,
PR
up to $99
$11.00
$13.00
$12.00
CALL
$100-399
$13.00
$15.00
$14.00
CALL
$400-799
$15.00
$18.00
$16.00
CALL
$800-999
$17.00
$19.00
$18.00
CALL
Film
Shipping charge of $6.00 for film orders over $20.00
CALL