For Shipment of tapes and DVDs to be Converted to a Different Format Please print this form, fill it in, and include it with your order Please Print Your Name_________________________________________________________________________________ Address _________________________________________________________________________________ City ______________________________________________________ State____ Zip Code _________ Email address ___________________________________________________________________________ Evening Phone Number: ( ) Daytime Phone Number: ( ) How you would like to handle payment for the conversion and copies:? Check One: A. Include your credit card number and we will charge your account with the conversion 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. What do you want printed on the label of the copy(s). Please Print: ________________________________________________________________________________ ________________________________________________________________________________ ________________________________________________________________________________ If converting from PAL to NTSC, what medium do you want the converted copies to be placed on (circle one): VHS; S-VHS; 8mm; Hi-8; Digital-8mm; Mini DV, DVD PLEASE NOTE: If the conversion is from the U.S. format(NTSC)to PAL or SECAM we can ONLY put the conversion onto VHS tape or DVD. What country is the original tape from? _____________________________________ In what country will the conversion be played? ______________________________ How many tapes or DVDs do you want in the new format?_________________________ 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! Ship to: VideOccasions 2806 129th Ave S.E. Bellevue, WA 98005 Business Hours Phone: 425-641-4811 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. Shipping Most of our customers ship tape 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 tape 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: VideOccasions 2806 129th Ave S.E. Bellevue, WA 98005