Channel-DV Mail Order Form
Please fill out with web browser, print, sign, and send this form along with your source materials. One form for each order.
Name:
 (First Middle Last)
Phone (w):
  Ext.   Phone (h)
Email::
Mailing 
Address:
 (Address Line 1)
(Address Line 2)
(Address Line 3)
Tape #
Source Format
Service Type
DVD Title and Additional Time
Unit Price
1
2
Add. Time in Minute
3
Add. Time in Minute
4
Add. Time in Minute
5
Add. Time in Minute
Miscellaneous/Surcharge
Shipping&Handling
Subtotal
5% Sales Tax (Massachusetts Residents Only)
Grand Total
Payment Method 
 Visa MasterCard Check/Money Order
Credit Card Number 
   Expiration Date mm/yy
Name Appear on Card

Signature number

Billing address if different from mailing address

TERMS AND AGREEMENTS:
Channel-DV will not digitized and/or author materials (video source) copyrighted by anyone other than the client without written authorization that permission to duplicate has been granted by the copyright owner. It is the sole responsibility of the client to ensure that if the source material is copyrighted, permission has been obtained from the copyright owner to duplicate the material. Channel-DV will make EVERY EFFERT to protect your source materials from damage, however we will not be held responsible for any unexpected damage that does occur. If any erasure, loss or physical damage occurs to the source tapes after digitization (at which point the client has the digital format of the footage), Channel-DV will compensate with a replacement tape of the same tape and length. If the damage occurs before digitization, resulting in the complete loss of the footage, Channel-DV will compensate with a replacement tape of the same type and length and free service of the same length as the lost footage. Channel-DV is not responsible for any loss in mail delivery.
SIGNATURE__________________________________ DATE______________________