Video Tape to DVD 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.      Questions? Call 800 662-8336

Name:
Company:
Address:
City:   State:
Zip Code:
Home Phone: Area Code:
Work Phone: Area Code:
E-Mail:

Payment Options:
Check, Money Order, MasterCard, Visa, AmEx, Discover


Credit Card # xxxx-xxxx-xxxx-xxxx

Exp. Date: Month Year

3 or 4 Digit Bank Code on Card

Choose a Graphic or Logo or  Background Image

   How long is your Video Minutes

What would you like printed on the labels?

 Type Size  Type Style

Line #1

Line #2

Line #3
  Quantity Price Each Total
Tape to DVD Disk Transfer(s)

$24.95

 $
Additional DVD copies 1-5=$12.00 / 6-10=$8.00  

 $
Shipping/handling for Disc Transfers and Copies.

1  Tape/Disk Transfer = $6.75

2 -  10 Disks/Transfers  =  $9.85
11 - 50 Disks/Transfers = $16.50
Sub Total

 $
Shipping

 $
Total

 $
Please read and sign.  I hereby authorize High-Tech Productions to transfer this video tape to a DVD. 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 & Special Instructions:

Need a Shipping Label for your Package?   Click Here

* If you have a problem with this order form, Click Here for our Alternate DVD Transfer Order Form

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