| Curtis Media Transfer
Video Services Order Form Thank you for trusting us with your memories. Please type your information on the order-form below, then press the "Print" button at the bottom of the page. |
Ship tapes to: |
| We accept all major Credit Cards, Pay Pal,
or Check. Please indicate payment preference below. Make check payable to Curtis Media Transfer. If you like, leave this area blank and we will contact you for payment when order is complete. Check Credit Card Pay Pal Contact Me for payment Ship tapes to: |
For credit card payment Name as it appears on card: Credit Card Number: Credit Card Type: Exp date: 3 or 4 digit Verification Number:
If
billing address is different than shipping address, include here:
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