Order form for Harlan Ellison Recordings



Order Section (PLEASE PRINT):

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|                            |     |        |_________POSTAGE__________|          |
| Item                       | Qty |   Cost |   US  | Canada | Oversea |   Amount |
|---------------------------------------------------------------------------------|
| HERC Membership or renewal |     |        |       |        |         |          |  
|   6 Newsletters            |     | $15.00 |   -   |    -   |         |          |
|---------------------------------------------------------------------------------|
| Paladin of the Lost Hour   |     |        |       |        |         |          |
|   Compact Disc             |     | $15.00 | $2.00 |  $2.00 |   $4.00 |          |
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| Jeffty is Five             |     |        |       |        |         |          |
|   Cassette                 |     |  $6.00 | $1.00 |  $1.00 |   $3.00 |          |
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| On the Downhill Side       |     |        |       |        |         |          |
|   LP                       |     |  $8.00 | $2.00 |  $2.00 |   $4.00 |          |
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| An Hour with Harlan Ellison|     |        |       |        |         |          |
|   Cassette                 |     |  $6.00 | $1.00 |  $1.00 |   $3.00 |          |
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| I'm Looking for Kadak      |     |        |       |        |         |          |
|   Cassette                 |     |  $6.00 | $1.00 |  $1.00 |   $3.00 |          |
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| The Prowler in the City... |     |        |       |        |         |          |
|   Cassette                 |     |  $6.00 | $1.00 |  $1.00 |   $3.00 |          |
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| California Residents please add 8.25% sales tax                      |          |
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|GRAND TOTAL                                                           |          |
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Note: When ordering three or more items, only pay postage on the two most expensive items. We will cover the rest.
Name : ______________________________________________
Date : ______________ Membership No.: ______________
Address: ______________________________________________
______________________________________________
______________________________________________


Please make checks/money order (US FUNDS ONLY) payable to:
The Harlan Ellison Recording Collection

Send to: The Harlan Ellison Recording Collection
P.O. Box 55548
Sherman Oaks, CA 91413-0548