Please print out this page and attach with order
VHS 2 DVD Conversion Order FormCompany Name: _______________________ Date: _________________________ First Name: _____________________________ Last Name: ____________________ Address: ________________________________________________________________ City: ________________________ State: _____________ Zip Code: _______________ Phone Number: __________________________ Fax: _________________________ Email: _________________________________
1. How many VHS tapes are you having transferred? _____________________________ 2. How many minutes per VHS do you want transferred? ___________________________ 3. Would you like extra copies of your DVD? __________________________________ 4. If you answered YES, how many copies would you like? _______________________ 5. Would you prefer standard TV ratio, or Widescreen? ___________________________ 6. How did you hear about us? _______________________________________________
Form of Payment: £ Credit Card Number _______________________________ Exp. __________ £ Check £ Cash Name as it appears on Credit Card:_________________________
Billing Address of Credit Card:_____________________________
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Please read and sign the following release form. fromVHS2DVD.com will not work on any material without a signed liability form.
LIMITATION OF LIABILITY—PLEASE READ CAREFULLY AND SIGN. By signing this form customer agrees that fromVHS2DVD.com, its agents and employees shall not be liable to the customer, for any losses or damages of any kind or nature to the customer’s tape, or other materials, whether direct, incidental, consequential or otherwise. Customer also accepts that they have reviewed the compatibility charts on our website and will not hold fromVHS2DVD, its agents and employees, responsible for lack of compatibility of DVDR on customer’s DVD player. Customer declares that all materials submitted to fromVHS2DVD.com for transfer or other reproductions are not in violation of any copyright laws. Customers will indemnify and hold fromVHS2DVD.com harmless with respect to any claim of violation of such laws. Customer either created the materials submitted or customer has permission of the copyright owner to duplicate them. A written release form must accompany all copyright material.
________________________________________________________ Customer Signature Date
Please print out this form and mail with payment and all material to: 959 E. Collins Blvd, Suite 123 Richardson, TX 75081
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