EverMedia
Multi-media Services
 Video to AVI
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.

Name                   

 

Official Use Only:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Company

 

Address

 

 

Post Code

 

Telephone (Day)

 

Telephone (Evening)

 

Email

 
 

Date Conversion(s) Required by

 

Please help us serve you better by filling our quick survey below.

Thank You

How did you learn about our service?

[  ] Internet Search Engine _______________
[  ] Newspaper Reviews _________________
[  ] Recommended By ___________________
[  ] Returning Customer
[  ] Other _____________________________

How do you rate our web site?

 

[  ] Informative                          [  ] Easy to use                     [  ] Tidy
[  ] Needs more information      [  ] Not easy to use              [  ] Untidy  
Other Comments:

What attracted you to use EverMedia?

 

 

Please include titles for each tape along with any special instructions (or attach separate sheet).

 

 

 

 

 

Order Items

Description

Qty

Unit Price

Total

Up to 30 Mins of Video to AVI (2 DVDs)


__

£19.50


£______

Up to 1 Hour of Video to AVI (4 DVDs)


__

£34.50


£______

Up to 1.5 hours of Video to AVI (6 DVDs)
 


__

£49.50


£______

Up to 2 hours of Video to AVI (8 DVDs)
 


__

£64.50


£______

Up to 2.5 hours of Video to AVI (10 DVDs)
 


__

£79.50


£______

Up to 3 hours of Video to AVI (12 DVDs)
 


__

£94.50


£______

Up to 3.5 hours of Video to AVI (14 DVDs)
 


__

£109.50


£______

Up to 4 hours of Video to AVI (16 DVDs)
 


__

£124.50


£______

Tape Surcharges (No Surcharges for PAL: VHS, VHS-C, Betamax, MiniDV, Video 8, Hi8, Digital 8, SVHS tapes)
For DVCam, Betacam SP or U-Matic Add £9.00 per source or maximum of £40.00 for more than 5 sources.
For MicroMV add £3.50 per tape.
For NTSC: MiniDV, Hi8, Video 8 Add £4.00 per source.


__


£____


£______

TV System Conversion Options:
[  ] NTSC to PAL Conversion
[  ] PAL to NTSC Conversion
 £5.00 per tape or a maximum of £40.00 per order


__


£5.00


£______

Additional Copies
DVDs @ £5.50 each
For quantities over 5 please contact us for discounts


__


£5.50


£______

Rush Job Surcharge (per tape/order)
3 Days @ +10%, 2 Day @ +20%, 1 Day @ +30%, Same-Day @ +40%
Subject to availability – Please check prior to placing order


__


£____


£______

Risk Free Delivery Service
Approximately £5.00 for first tape + £1.00 per additional tape. Please call for pricing or exclude and we will bill on delivery.



 


£______

Total Order

£______

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 __________________