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Ship To: |
Bill To:
(if different than Ship to) |
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Name*
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Name
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Organization*
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Organization
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Street Address*
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Street Address
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City, State, ZIP*
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City, State, Zip
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Phone*
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Phone
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Email*
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Email
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Date*
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Purchase Order # (optional):
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Quantity
(see DVD Prices) |
Subtotal |
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Hard Case:
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= $
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Paper Sleeves:
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= $
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Broadcast License:
(Please complete
License and
email, mail
or fax)
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= $
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+ $
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$
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Special instructions or comments:
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By clicking Submit, you agree to
pay the "Total Amount Due" within 30 days of receiving
your shipment. A $5 late fee will be assessed for unpaid bills
past 30 days. Your invoice requesting payment and new DVDs
will be shipped in 2-3 weeks from order date. |
