Videoworx Productions 105 Serra Way #380 Milpitas, CA 95035 408-956-1620 videoworx@comcast.net Video Order Form Customer / Ship to: Name Address City Phone Email State Qty Date: ZIP Description 2014 Bay Area Dance Recital Unit Price Amount (Shipping Included) $45.00 Tuesday, June 10, 2014 DVD Features: * Captured in High Definition Video * Edited Multi Camera Production * Custom Authored DVDs with Chapter Stops Sub Total Payment info: Cash Check (payable to: Videoworx) Credit Card # _________ - _________ - _________ - _________ Expiration _____/_____ CVV: ______ Office Use Only Sales Tax (8.75 %) See table below TOTAL Amount $45.00 $90.00 $135.00 $180.00 $225.00 Tax $3.94 $7.88 $11.81 $15.75 $19.69 Thank you for your order. Please allow up to 6-8 weeks for editing, duplication and delivery.