Please complete this order form, print, and send with your
Credit Card information, Check, or Money Order to:
CHANNELL VIDEO PRODUCTIONS
563 North 355 West
Orem, Utah 84057





Quantity: Slide & Photo Transfer Order Form
If you need help filling out the order form call 1-800-405-4809
Minimum Order 200 Slides or Photos
Enter the number of Slides to be transferred .75¢ per slide
Enter the number of Photos to be transferred
.75¢ per photo
Instrumental background music: Yes No
(No charge for our pre-made instrumental music background)
Additional DVD Copies
$10.00 per disc
Text Title Printed on the DVD Disc
Return Shipping & Handling "Required"
(Enter the number of Images to be transferred)

"Click Here" for TOTAL






Name:
Address:
City:
State:
Zip Code:
Phone:
Email:
Payment Options: Card Type:
Card Number:
Expiration Date: Month Year: Month

" The CVV2 number is a fraud-prevention measures implemented by VISA and MasterCard.
The 3 digit number is printed (not imprinted) on the back of the card,
just after the credit card number."
CVV2:
I agree to pay the total amount according to the card issuer agreement.

Cardholder's Signature:__________________________________ Date:_____________

If paying by check or money order, make payable to CHANNELL VIDEO PRODUCTIONS
Only checks drawn on US Banks or domestic money orders in US $ will be accepted.
Channell Video Productions is not responsible for items lost or damaged during shipping.
For your protection you should insure or register any items that are valuable or irreplaceable.
CAUTION: Don't write on the back of pictures with an ink pen or marker
they will often bleed onto the next picture on the stack.
We recommend using post-it notes stuck on the back side of each picture.
Slides can be numbered with a pencil or pen on cardboard edge.
Slides & Photos not numbered will be transferred in random order.