Film Transfer Order Form
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Print this form, fill it out clearly, sign it and send it with your order to: Discount Duplication, 240 Oxmoor Circle, Suite 102, Birmingham, AL 35209 |
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Name ______________________________________ Address ______________________________________ City ______________________________________ State _________________ Zip ________________ |
Phone ( )_________________________ E-Mail ________________________________ |
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If Paying by Credit Card Circle Credit Card Type |
American Express Discover Mastercard Visa |
| Account#_________________________________ | Exp. Date________ | CVV Code________ | Signature______________________ |
| 8 mm & Super 8 | 16mm |
| _________ # of 50 ft reels (3 in.) | _________ # of 50 ft reels (3 3/4 in.) |
| _________ # of 200 ft reels (5 in.) | _________ # of 100 ft reels (5 in.) |
| _________ # of 300 ft reels (6 in.) | _________ # of 400 ft reels (7 in.) |
| _________ # of 400 ft reels (7 in.) | _________ # of 1600 ft reels (13 3/4 in.) |
Please number your reels in the order you
would like them to appear on your tape or check here ___ No particular order
1 DVD-R Digital Disc Master Included
___ Basic (Silent) ___ Standard (Music)
______ # additional viewing copies for friends and family members, DVD $2.99 each
Please read and sign. 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 Discount Duplication, 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 this service including shipping and handling to be charged to my card. If for any reason you should pick up your film without purchasing the film transfer, you will be charged for film editing, splicing, reels, cleaning and technician labor. Reels $2.00 each, splices $1.00 each, editing labor $50.00 per hour.
Authorized Signature_____________________________ Date_____________
Follow this link if you would like a Shipping Label for your Package Shipping Label Link