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Family History________ |
Name:____________________________________________________________ |
We kapture moments that last a lifetime! |
Closing VideoTitling:______________________________________________________ |
Shipping Address:___________________________________________________ |
City:__________________________ State:___________ Zip Code:____________ |
Phone:______________________________________________________________ |
Number of Pictures:______________________ |
Please Check Video Type: |
Wedding____________ |
Anniversary__________ |
Birthday_____________ |
Memorial Tribute______ |
Other_______________Event:___________________________________________ |
Titling for Label:________________________________________________________ |
Opening Video Titling:_____________________________________________________ |
Music Selection ( Choose four songs for 75 pictures) See the Songlist for music available. |
1.)____________________________________________________________________ |
2.)_____________________________________________________________________ |
3.)_____________________________________________________________________ |
Please enter corresponding amount |
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Additional Photos ($1.50 each) |
Additional Titles ($2.00 each) |
Additional VHS Copies ($25.00 each) |
DVD ($35.00 each) |
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Video Photo Montage ($150.00) |
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Make sure to choose a reliable service that requires a signature to deliver your photos. *PLEASE TYPE OR PRINT TITLES CLEARLY. *PLEASE DO NOT SEND FRAMED PICTURES. *PLEASE SEND AN E-MAIL NOTIFYING US ABOUT *THE ORDER YOU ARE SHIPPING, DATE OF *SHIPMENT AND NUMBER OF PHOTOS. |
Send Check or Money Order to: Kaptured Moments Video Productions 765 Terrace Court, #201 Elgin, Il 60120 |
Thank you for placing your order with us. |
Print this page and send along with your photos and/or video clips. |
Title/Artist |
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