WORK ORDER

PLEASE PRINT THIS FORM AND INCLUDE WITH VIDEO SHIPMENT.

ALL LINES MUST BE FILLED OUT COMPLETELY

Customer Name:________________________________________________________

Daytime Phone Number:_________________________________________________

Format Supplied________________________     Quantity Supplied______________

Transfer To:____________________________________________________________

Number of Masters:______________    Number of Copies________________

FILM: FPS_______   FILM IS:     COLOR        B & W     NEG.     POSITIVE     INTERLOCK

Any Special Instructions:

If Return Shipping To You Please Supply Shipping To Address: (Fed-Ex or UPS Only)
NO POST OFFICE BOXES

 All orders must be paid for before we ship them back to you - Visa, Mastercard or Discover.  Checks will be accepted WITH an imprinted address, phone number and the ID of the check writer.  Shipping charges are additional along with a $7.00 handling fee per box.

 Visa_______        Mastercard__________Discover______________

I authorize Film & Video Transfers, Inc. to charge my credit card for the above mentioned transfer.

 ____________________________________________________

Sign, Print and Date

CREDIT CARD NUMBER MAY BE GIVEN TO LAB FACILITY OVER THE PHONE

 ANY ORDERS SHIPPED COD WILL BE PAYABLE BY MONEY ORDER OR CASHIERS CHECK ONLY

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