WORLD VIDEO ELECTRONICS, INC.
3948 Sunbeam Rd. Ste. 6, Jacksonville, Florida 32257
Phone: (904) 731-7474 Fax: (904) 733-8768

MOVIE FILM TRANSFER 
ORDER FORM

Please complete this form, print it out, and attach with your order.
NAME:
ADDRESS:
CITY:
STATE:
ZIP:
HOME PHONE:
WORK PHONE:
E-MAIL ADDRESS:
Payment Options:

Account #

Expiration Date:  
Name as it appears on my credit card for this purchase.


Signature:
______________________________


Return Shipping and Handling Preference:

Please mark services requested:

8mm/Super 8feet

16mm  feet. 
(Leave blank if you are not sure)

How many total copies should we produce for you?

We recommend to have at least one additional copy and keep this master tape in a safe place.

Opening Title:

Closing Title:

If you are providing the music,  please write or type  the song title, track, album etc. on a separate piece of paper.

Face Label:

Spine Label:

How did you find us?

Terms and Conditions: I authorize the above stated work to be performed. I understand that I am responsible for any royalties which may be due, for obtaining permission to duplicate any copyrighted materials, and for the total content of the finished duplication. I do not hold World Video Electronics, Inc. liable for anything that should happen to property left, due to mechanical, technical, fire, flood, or natural disaster. If paying by credit card, I authorize the charges for the costs associated with this order including shipping and handling. Note: Florida residents will be charged 7% state sales tax.

I have read the agreement and submit my order to World Video Electronics, Inc. in accordance with the preceding terms and conditions:

Authorized signature____________________________  Date________________

Need a Shipping Label for your Package? Click Here

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