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First Person Video
Order Form

Please print and fill out this form.   Mail this form with payment to:

MovieMaker, Inc.
P.O. Box 3413
Boulder, CO 80307

Date _______/_______/_______

Please send VIDEO to:

Name _____________________________________________

Address ________________________________________ Apt# _______

City __________________________ State _______ Zip ____________

Phone (______)-________-______________

Circle Pay't Method:  Check   /   Purch. Ord.   /   VISA   /   MC  

Include Credit Card / P.O./ Check# ___________________________

QUANTITY ________ @ $90.00 each = $__________

+ 10% Shipping and Handling = $__________

Check Total = $__________




THANK YOU FOR YOUR ORDER!