Video Doc Productions - Combining Your Ideas With Our Technology Since 1991

WORK ORDER

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PLEASE PRINT THIS FORM AND INCLUDE WITH YOUR SHIPMENT.

ALL LINES MUST BE FILLED OUT COMPLETELY

PLEASE P R I N T CLEARLY

Customer Name:_________________________________________________________________________________

MAILING ADDRESS: (We only Ship via UPS)______________________________________________________________

City: _______________________________________ STATE: __________________

ZIPCODE: ______________

Daytime Phone Number:_________________________________________________

Format Supplied________________________ Quantity Supplied______________

Number of Masters:______________ Number of Copies________________

ARE FILM REELS NUMBERED AND IN ANY PARTICULAR ORDER:

YES______ NO ______ RANDOM ______

WOULD YOU LIKE US TO ADD EASY-LISTENING INSTRUMENTAL BACKGROUND MUSIC?

YES ______ NO _____

TITLE TO BE ADDED AT THE BEGINNING OF THE VIDEO: ________________________________________________________

(Example: Rudolph Home Movies 1965 - 1978)

Any Special Instructions: _______________________________________________________________________________________

____________________________________________________________________________________________________________

UPS WILL NOT SHIP TO POST OFFICE BOXES.

Checks will be accepted. Orders will ship when check clears.

Shipping charges are additional.

I authorize Video Doc Productions to complete the work submitted for the above mentioned transfer.

____________________________________________________

Sign, Print and Date

YOU MAY PAY BY CREDIT CARD BY CALLING OUR OFFICE AT 412-835-0643