EverMedia
Multi-media Services
Analogue
to Digital Tape Conversion
Order Form
(Valid until end Dec 2008)
Please print, complete
and send this form together with your payment and video tapes to:
EverMedia Ltd, A3, Moor Lane Business Centre, Moor Lane, Widnes,
Cheshire, WA8 7AQ, England, UK
Name & Address
EverMedia does not disclose your information to any
third-parties.
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Name
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Official Use Only: |
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Company |
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Address |
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Post Code |
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Telephone (Day) |
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Telephone (Evening) |
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Email |
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Date Conversion
Required By |
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Please help us serve you better by filling our quick survey
below. Thank You |
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How did you learn
about our service? |
[ ] Internet
Search Engine _______________ |
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How do you rate our
web site? |
[ ] Informative [
] Easy to use
[ ] Tidy |
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What attracted you
to use EverMedia? |
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Please
include titles for each tape along with any special instructions (or attach
separate sheet). |
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Order Items |
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Description |
Qty |
Unit Price |
Total |
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Video to
MiniDV (PAL) – per hour |
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Video to
Digital 8 (PAL) – per hour |
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Additional
10 Minute chunks past 1 hour |
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Tape
Surcharges (No
Surcharges for PAL: VHS, VHS-C, Betamax, MiniDV, Video 8, Hi8, Digital 8,
SVHS tapes) |
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TV System
Conversion Options: |
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Blank
MiniDV or Digital 8 Tapes |
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£4.50 |
£______ |
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Rush Job
Surcharge (per tape/order) |
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Risk Free
Delivery Service |
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Total Order |
£______ |
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Order Confirmation
I have read, understood and agree with the terms and
conditions of service (as published at www.EverMedia.co.uk).
Please Tick one:
[ ] I am enclosing a cheque/postal
order for £_______ made payable to "EverMedia".
[ ] I would like to pay by Credit Card
online using PayPal secure payment system. I understand this is subject to 4%
surcharge. Please send PayPal invoice to my email address.
[ ] Inform me of the final costs and I
will send full payment within 48 hours of notification.
[ ] Invoice my company [ ] by email to
_______________________ (email address)
(Terms: 7 days) Our Order Reference
__________________________
I accept full responsibility for the content of my original videos being copied
or converted to the requested media.
Signature
_______________________________ Date __________________