DVD Duplication Order Form
Print this form out, fill in, sign and send with your check or money order
to:
High-Tech Productions 699 NW 9th Ave. Boca Raton, FL 33486
Orders will be processed and shipped within 24 hours.
* Florida residents add 6.5% sales tax to total
of order. Please Print Clearly.
Name_____________________________________ Phone # ( ) _____________________
Company________________________________________________________________________
Address____________________________ City_________________ State_____ Zip______
If paying by credit card, Account #__________________________________ Exp. Date____/____
3 or 4 Digit Bank Code on Card:________ Signature_____________________________________
| Quantity | Price Each | Total | |
| DVD Copies | |||
| Alternate Packaging (Jewel or Amray style case instead of Sleeve) | |||
| Shipping/handling
for DVD Copies. 1 - 5 Copies =
$6.75
101-250 Copies =
$28.75 |
Sub Total | ||
| Shipping | |||
| Total | |||
What do you want printed on the disc? Background or Graphic Image ___________________
Line 1)_______________________________________________________________(Size) s M L
Line 2)_______________________________________________________________(Size) s M L
Line 3)_______________________________________________________________(Size) s M L
Please read and sign. I hereby authorize High-Tech Productions to duplicate this DVD. I own all rights to this disc and will not hold High-Tech Productions liable for copyright infringement. I assume full responsibility for obtaining releases when required for sale and distribution. I hereby agree that the handling, processing and packaging is without warranty or liability, even though defects, damage or loss by negligence or other fault may occur, furthermore, I agree to hold harmless and indemnify High-Tech Productions for any and all liability and/or claim arising from this transaction. I have also read and agree to High-Tech Productions Returns Policy. If I am paying by credit card, I authorize the charges for the costs associated with this order including shipping/handling and any applicable taxes.
Authorized Signature___________________________________________ Date_____________
Remarks__________________________________________________________________________
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