Video Tape to Disc
Transfer 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 | |
| First Disc Transfer | 1 | $24.95 | $24.95 |
| Additional copy's 1-5=$12.00 6-10=$8.00 | |||
| Shipping/handling
for Disc Transfers and Copies.
1 Disc's =
$6.75
7-24 Disc's = $16.50 |
Sub Total | ||
| Shipping | |||
| Total | |||
Background
or Graphic Image
______________
Length of your material_____min.
What do you want printed on the disc?
Line 1)______________________________________________________________________________
Line 2)______________________________________________________________________________
Line 3)______________________________________________________________________________
Please read and sign. I hereby authorize High-Tech Productions to transfer this video tape to disc. I own all rights to this video 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. 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. I also understand that Disc transfers are not refundable because of incompatibility.
Authorized Signature___________________________________________ Date_____________
Remarks__________________________________________________________________________
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