EAGLE VIDEO OFF-LINE ORDER FORM

Name:________________________________________________________

Address:______________________________________________________

City:__________________________ State:___________________ ZIP CODE: _____________

Phone #: _______________________

ORDER

Item 1____________________________________________Price:______________

Item 2____________________________________________Price:______________

Item 3____________________________________________Price:______________

Item 4____________________________________________Price:______________

Item 5____________________________________________Price:______________

Item 6____________________________________________Price:______________

Item 7____________________________________________Price:______________

SUBTOTAL :_____________

TOTAL :______________

SHIPPING CHARGES VIA UPS GROUND -

1 DVD: $7.00 Each additional DVD, add $1.00 per Video

RIGHTS ON VIDEO MOVIES:
All programs licensed for home and non-theatrical use only. Duplication and broadcast in any form are prohibited.

Signature: ____________________________________Date: _________________________

Download and print this form then MAIL the COMPLETED ORDER TO:

Eagle
82 Oak Avenue
Tenafly NJ 07670