Company Name______________________________________________
Your Name______________________________________________________
Phone ____________________________________Ext:_________
Email _____________________________________________________
SHIP VIDEOS TO:
Address _________________________________________________________
City ______________________ State _____________ Zip Code __________
Date Tape(s) needed by ______________ For _____ Days (maximum 30 days)
VIDEO SELECTIONS:
Video #1 ________________________________________________Time:______
1st Alternate____________________________________________Time:______
2nd Alternate____________________________________________Time:______
Video #2 _______________________________________________Time:______
1st Alternate____________________________________________Time:______
2nd Alternate____________________________________________Time:______
Video #3 _______________________________________________Time:______
1st Alternate____________________________________________Time:______
2nd Alternate____________________________________________Time:______
Video #4 _______________________________________________Time:______
1st Alternate____________________________________________Time:______
2nd Alternate____________________________________________Time:______
Comments:_________________________________________________
__________________________________________________________