P.O. Box 863778 Plano, TX 75086-3778 1-888-668-5903
VIDEO SERVICES ORDER FORM Contact Information
*Name *Address *City *Home Phone *Email Address How did you hear about Permanent Treasures? *Cell Phone *State *Zip *Work Phone
Shipping Information - Delivery of completed order will require a signature
*Name *Address *City *State *Zip
Video Package Information
Circle or Highlight Service Required and indicate number of tapes to be transferred or converted Basic # Deluxe # DVD+R Advanced DVD-R *The date your movie is required #
Type of DVD Required (circle or highlight) Enter other details about your Home Movie Package *DVD Title (To be printed on DVD case/label)
Video Package Production On a separate sheet, please do your best to describe what editing needs to be done (if any) to produce your video. Please do your best to provide as much information as possible to enable our technicians to identify the sections to keep and/or delete. Example: Start at the beginning and work your way through indicating what happens to signify the start and what signals the ending of the clips to be included and/or deleted. Image For Case Cover/Label *A scene from the home movies (please give a description using number of people, color of clothes, background etc.)
Video File Creation
On a separate sheet, please do your best to describe the approximate position of the scene/clips in the movie that you want preserved, perhaps how long into the movie, what happens to signify the start of the clip and what signals the ending. Please list each scene separately with as much information as possible to enable our technicians to identify the sections required. Video File Format (Circle or highlight) AVI YouTube Other (Specify) Other (Specify) Video File Upload Site (Circle or highlight)
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Payment and Return Delivery
*Circle or Highlight your Method of Payment Pay Pal Money Order/Cashier’s Check Personal/Business Check *Circle or Highlight desired Return Delivery Method Priority Mail (2-3 business Days = $20) Express Mail (next business day delivery = $30)
Items Ordered
Material Basic Video Transfer ($20 per tape) Deluxe Video Transfer ($50 per tape) PAL – NTSC conversion ($60 per hour) Video File Creation ($15 per clip) Video File Upload ($10 per clip) Priority or Express Mail ($20 or $30) Number of Items Cost
Total
Permanent Treasures Client Agreement
By submitting photographs, videotape, photo negatives, photo slides or any other type of media to Permanent Treasures for inclusion in our DVD photo montages, I acknowledge and agree that Permanent Treasures shall not be liable for any loss or damage to these materials during the shipping process, either to or from the Company. I understand and agree to release Permanent Treasures from all liability resulting from mishandling or loss during shipping, regardless of carrier used or method of transport.
Permanent Treasures does not transfer, copy or encode copyrighted materials. Permanent Treasures does not and will not transcribe or encode any video with region encoding or copy protection.
I certify that I own the right to order or create copies of all video material. I understand that when electing the Youtube or other online video sharing options, Permanent Treasures has the right to distribute the video via online video sharing services, and agree not to hold Permanent Treasures liable for issues arising from posting such materials in a public forum. I understand Permanent Treasures reserves the right to refuse to transcribe, encode or post online materials found objectionable, or which may violate standards.
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Customer Signature:
* Date:
Permanent Treasures P.O. Box 863778, Plano, TX 75086-3778 Toll-Free: 1–888–668-5903 Dallas/Fort Worth Metroplex: 214-668-5903
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