For Shipment of Materials for DVD creation, and DVDs for DUPLICATION Please DO NOT Use this Form for TAPE DUPLICATION. Use the Tape Order Form. Please Print Your Name ______________________________________________ Address_____________________________________________________________ City____________________________________ State _______Zip Code________ Daytime Phone Number ( ) Evening Phone Number ( ) Email address: _______________________________________________________________________________ What is the exact nature of the work you want done: e.g., "I'm sending you two DVDs. Please make three copies of each. Keep the printing on the disc the same as the original." Or "I'm sending two VHS tapes to be put onto DVD. Please combine onto a single DVD if possible." ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ If other than what is on the face of each DVD you send, what do you want on the DVD copies? Please Print your description and the words you want on the face: _______________________________________________________________________________ ________________________________________________________________________________ How you would like to handle payment? Circle One: A. Include your credit card number and we will charge your account with the transfer and copy costs, shipping and handling charges. Your card will not be charged until we are ready to ship the order. Please supply: Card Type: M/C Visa (we cannot accept Debit Cards, American Express or Discover Credit Cards) Card Number: __________________________________________________________________________ Expires (mm/yy) _________________________________ Three digit security number on reverse of card __________________ B. Have us e-mail you when the order is ready to ship and you may call us with your credit card number. C. Have us e-mail you when the order is ready to ship and you can send us a check. We will ship your order when your check clears. Please contact VideOccasions with any questions you may have before you send us your tapes for duplication. Please print this form, fill it in, and include with your order. VideOccasions Business Hours Monday - Friday 10:00 a.m. to 6:00 p.m., Pacific Time Zone Thursday 10:00 a.m. to 5:00 p.m., Pacific Time Zone Please remember: When it's 10:00 a.m. in New York, it's only 7:00 a.m. in Seattle. Most of our customers ship film to us via the U.S. Postal Service, although we also receive shipments via UPS , Fed Ex and other carriers. We suggest that regardless of the method you choose to ship your order you request "tracking" of the package so that both you and the carrier will know at all times the whereabouts of the package. Ship to: Contact: VideOccasions jack@videoccasions-nw.com 2806 129th Ave S.E. 425-641-4811 Bellevue, WA 98005