Order Form

Name: ___________________________
Street Address: _____________________________
City: _______________  State: ___  Zip: _______

Daytime Phone: _______________  Evening Phone: ____________
Your E-mail Address: __________________

Video Copies

How Many: ______ 	Length of Tape: _________

How did you want   	_____________________________
the tape labeled?       _____________________________

Special Instructions: ______________________________________

____________________________________________________________


VHS-C & 8mm mini cassettes		# of Tapes Sent:    _______
(limit 4 to a VHS Tape)
Number them for order to appear	How Many copies of
					finished tape:	    _______

Special Instructions: ______________________________________

____________________________________________________________


Video Repair

# of Tapes that need repair: ________

What is wrong with the tape: ________________________________

____________________________________________________________

Copies of the tape needed after repair: __________

(Be sure to give phone number and name above so we can contact with any questions)


Total number of copies___ @ $______each $________

Total number of repairs____ @ $______ each $_______

Total cost of vhs-c & 8mm order $________
(remember it's $ 10.00 for the
first mini cassette put on vhs
and add $5.00 for each one 
after that up to 4 on one tape)

HOME MOVIES TO VIDEO TAPE

# of  50 ft reels ___ x  50 ft = _____ total footage for  50 ft reels
# of  200 ft reels ___ x 200 ft = _____ total footage for  200 ft reels
# of  400 ft reels ___ x 400 ft = _____ total footage for  400 ft reels

                                                          
               $ _______ total estimated footage for the above reels x.08 ,
				8 cents a foot
                                          
               $ _______ cost of the film transfer

               $ _______ add $5.00 tape cost for orders up to 1,600ft
					(add $10.00 for orders OVER 1,600ft)
# of  extra copies ___  $ _______ add $10.00 for a 1 tape copy 
				and $15.00 for a 2 tape copy
                             
                $ _______ Total cost of the order with all the above totals added             

* (WE REALIZE THAT YOU MAY HAVE TROUBLE ESTIMATING 
THE TOTAL FILM FOOTAGE. SO WE WILL GIVE THE EXACT TOTAL
OF FILM FOOTAGE WITH YOUR RETURN ORDER, ALONG WITH ANY 
PRICE CORRECTION. IF THERE IS ANY ADDITIONAL CHARGE, WE
WILL LET YOU KNOW BEFORE STARTING ON YOUR FILM TRANSFER.

Shipping & Handling charges        $ _______ total cost of services
1-10 copies or repairs add $4.00                                        
for each additional 20 add $2.00   $ _______ shipping & handling
                                                          
                                   $ _______ Subtotal
                                          
                                   $ _______ Add 6% sales tax (WV Residents)

                                   $ _______ Total of order 
            
Payment Options(check one)
Check___   Money Order___ Visa___ Mastercard____ Discover_____
American Express____ Card Number ___________________ exp date_______
3 digit code on back of card_____ 4 digit code on AMEX cards______

Name as it appears on the card ________________________
Billing address for the card _________________________________
your phone number is case we have questions____________________

* all the above information is required to process your credit card.
any information not included will delay processing of your video order.