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Video Capture Order Form
If you have any questions about our services or need help with your order, email us.
Please print and fill out this form and fax, Toll-free, to 1-877-573-7045 or mail to:
PhotoVid
4409 Buckley Rd.
Lisle, IL 60532
ATTN: TOM THORNTON
How many video tapes are you including? |
____ VHS ____ 8mm |
Please have your video tape set close to the frame you would
like captured. Include a brief description of the image. Describe:
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What type of file would you like the image saved as? |
____ .jpg |
____ .bmp |
____ .tif |
____ .gif |
What type of disk would you like your image save on? |
____ 3.5" floppy |
____ Zip |
____ CD |
|
What will you be using the image for? For example: email,
webpage graphic, printing, etc. |
Explain: |
Will you be using your file on PC or Mac? |
____ PC |
____ Mac |
Your Name: |
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Your Street Address: |
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Your City, St, Zip: |
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Your Email Address: |
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Your Phone Number: |
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If you are paying by check we will email an invoice to you and your order
will be shipped upon receipt of your check or money order. If you are paying by
credit card please fill out the information below. |
Method of Payment:
____ Check
____ Money Order
____ Visa ____ Mastercard |
Card Holder Name: |
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Card Number: |
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Expiration Date: |
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