Either print this form from your browser or

Download this form as a 25K PDF

Adobe¨ Portable Document Format (PDF) is the open de facto standard for electronic document distribution worldwide. PDF is a universal file format that preserves all of the fonts, formatting, colors, and graphics of any source document, regardless of the application and platform used to create it. PDF files are compact and can be shared, viewed, navigated, and printed exactly as intended by anyone with a free Adobe Acrobat¨ Reader.

Video Out Distribution Tape Order Form

Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Shipping Address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Telephone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

E-mail: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Titles Requested:

Title & Artist: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

( ) Preview Format (VHS) or ( ) Exhibition Format (VHS, 3/4" U-matic, BetaSP)

Send via: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Delivery Date: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Do you wish to include Publicity Materials: (CVs, images, tape descriptions...)

Yes ( ) No ( )

Please Print out this form fill out and Fax to the Video Out Distribution Office.

For further assistance contact
Video Out Distribution
1965 Main Street
Vancouver, British Columbia V5T 3C1
Canada
Tel (604) 872-8449
fax (604) 876-1185 or e-mail: videoout@telus.net