Order Form

Prices current through August 30, 2009.

To order Institute products, please print this form and send with a check or a purchase order payable to University of Minnesota (tax ID # 416007513) at: Publications Office, Institute on Community Integration, University of Minnesota, 109 Pattee Hall, 150 Pillsbury Dr. SE, Minneapolis, MN 55455. Orders for free items may be phoned to (612) 624-4512 or faxed to (612) 624-9344. Orders cannot be taken electronically. Note: This form may print in two pages.

Publication (please print or type title fully):	Price per copy	Quantity	Total price
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Publications Total	$ __________
Sales Tax (Minnesota only. Does not apply if tax-exempt. See note below for rates*)	$ __________
TOTAL	$ __________

Purchase Order/Check Number: _____________________________

Orders must be accompanied by purchase order or check payable to University of Minnesota (tax ID # 416007513). We reserve the right to limit quantities on complimentary items. Prices include shipping within the U.S. (by Media Mail); for information on other shipping options and costs, contact the Publications Office. Tax-exempt Minnesota organizations: Please provide copy of exemption certificate if first time ordering.

Name ________________________________ Phone ____________________

Agency _________________________________________________________

Address _________________________________________________________

City ________________________________ State _______ Zip _____________

*Minnesota Sales Tax Rates:

Minneapolis = 7.4%. Hennepin County outside Minneapolis = 6.9%.

St. Paul = 7.25%. Ramsey County outside St. Paul, as well as Anoka County, Dakota County, Washington County = 6.75%.

Albert Lea, Austin, Baxter, Bemidji, Brainerd, Clearwater, Hermantown, Mankato, New Ulm, North Mankato, Owatonna, Proctor, Rochester, St. Augusta, St. Cloud, St. Joseph, Sartell, Sauk Rapids, Two Harbors, Waite Park, Willmar = 7%.

Duluth = 7.5%. Elsewhere in Minnesota = 6.5%.

End of Order Form