Customer Name:
Company Name:
Street:
Suite/Apt:
City: State: Zip:
Phone: Email:

How did you hear about us?

SD cards
XD cards
Thumbdrives
Memory Sticks
Compact Flash cards
SmartMedia
Other:

Yes, I would like to order additional duplicate copies of the DVDs. ($9.95 per DVD duplicate)

Yes, I would like to add custom text to be printed on the DVD (50 character limit) for an additional $4.99:

All orders are returned via USPS Priority mail for a flat rate for S&H of $19.95 per total order unless noted below:

Alternate Return Shipping Option - I would like you to return my entire order via FedEx Domestic, 2-day delivery (P.O. Boxes not accepted) instead of USPS Priority Mail and charge my credit card accordingly for shipping and handling. I am aware this costs more than USPS Priority mail.

Yes, I would like to add signature receipt confirmation. Please charge an extra $9.95 per order.

Please return my original box with my shipment for an additional $9.95 (If not checked, your original box will be discarded to make return shipment easier)

Please complete the info below.  We accept all major credit cards.

Card Type: Visa      Mastercard      Amex      Discover
Name Printed on Card:
Credit Card Number:
Expiration Date (MM/YY):

Billing Address (if different than shipping address)
Street: Suite/Apt:
City: State: Zip:

FOR OFFICIAL USE ONLY