Service Order Form (Please complete entirely.)

Ordering Instructions:
Step 1): Print this form out.
Step 2): Clearly and legibly print in your information.
Step 3): If sending multiple source tapes/films/slides, please number them in the order you would like them to be put onto your DVD(s). If ordering a Hollywood Plus DVD, be sure to include notes on where you want your chapter marks (i.e., time codes, obvious event changes, or at set intermals such as every 5 mins.).
Step 4): Pack your tapes/film/slides carefully (if tapes, group together & wrap in aluminum foil for added protection). Include this order form and a check made payable to "Dr. DVD." You are welcome to call or e-mail us in advance to confirm the amount of your order.
Step 5): Ship your order via a trackable method, with signature required. We will contact you confirming receipt, if there are any new questions, and when the project is completed. We'll e-mail you when your order ships.
 
Address: 1008 Pepper Avenue, Sunnyvale, CA 94087
Phone: 408.737.9DVD (9383) or Toll Free: 1-877-DVD-9DVD
Email: info@DrDVDmd.com

 
Customer Info:
Full Name:
Daytime Phone (please include area code):
Evening Phone (please include area code):

Street Address:

City/State/Zip:
Email:

 
Dr. DVD Service:
Number of original source tapes/films/slides to be converted:
Format of tape/films/slides:
Total approximate length/duration (in minutes):
Tape/films/slides condition (circle one): Good / Fair / Poor
Last time played (how many months/years ago)?
Tape/film/slide contents:

DVD quantity desired (Note: Each DVD holds up to 2 hrs. of footage.) Would you like us to a) put as much footage as possible (combining source tapes as necessary) onto each DVD or b) create one DVD per each of your source tapes/films?:

 

 
For Hollywood Plus orders only:

DVD Title (i.e., "Our Family Movies" or "Baby's First Year"). Please write it exactly as you wish it to appear:

 
Date Range (to be included as subtitle):
Photo, included on packaging (circle one):
Choose one for me / Use a snapshot of this particular scene: Reel/tape/slide #:_____ Time code (if applicable):______________
Extra menu enhancements (please see Price List for additional charges):
Background photo in menu (same photo will be used in menu as on packaging): Reel/tape/slide #:_____ Time code (if applicable):________________
 

 

 

Payment Itemizations:
Conversion to DVD ($69 or $139): $ ____________
Film conversion $0.16/ft. (if applicable): $ ____________
Slides conversion $0.99/slide (if applicable): $ ____________
Additional options (i.e., additional source tapes, invisible chapter marks, menu extras, slide show option, video restoration, editing): $ ____________
Additional copies $20 per copy (complete with "safe box" case, insert, and disc label $ ____________
Sales Tax 8.25% (only if in CA) $ ____________

Shipping & Handling

*Items include your source tapes & our DVDs

 $ ____________
1-5 items*: $20  
6-10 items*: $25  
11-15 items*: $35  
16-20 items*: $45  
21-25 items*: $55  
26-30 items*: $65  
31-35 items*: $75  
  Call or e-mail us if you have more than the number of items listed above.  
Total enclosed (Payable to "Dr. DVD") $ ____________

 

 

OUR GUARANTEE: Within 30 days, if for any reason you don't like the quality of your DVD conversion, we'll refund your money without any hassles. Some companies do not offer a refund at all. Dr. DVD agrees to take exceptional care in the handling and processing of all tapes/films/slides, solely for the purpose of transferring them to DVD. Only well-maintained professional equipment will be used to play back your tapes/film/slides, usually only once. Submitting any video tapes/films/slides to our company for conversion or other handling constitutes an agreement by you that any damage or loss by our company or employees, even if caused by frailty, age, or any other reason, will only entitle you to replacement with a like amount of new video tapes/films/slides. Dr. DVD, and its employees, cannot be held liable for tapes/films/slides that are or become damaged. We are not responsible for any videos/films/slides that are not picked up within 30 days of completion.

 

Typical turnaround time is 10 business days from receipt and we will notify you when your DVDs are ready for pickup or shipment.

 

 
I have read and agreed to the above.

 

Customer Signature: ________________________
Date: _______________
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