Quartz Productions Order Form

QTY	DESCRIPTION
0 1 2 3 4 5	Region 2 (UK) £19.99     East Devon Nature DVD
0 1 2 3 4 5	PAL £14.95 NTSC £16.95    The Axe Valley Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95    The Pearl of Dorset Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95    The Otter Valley Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95    The Summer Fliers Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95     A Beginners Guide to Pressed Flowers Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95 DV PAL £25     The Music of the River Axe Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95 SECAM £16.95     Images of Exeter Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95 SECAM £16.95     Images of Dartmoor Video
0 1 2 3 4 5	PAL £14.95 NTSC £16.95 SECAM £16.95     Images of the English Riviera Video
	POST & PACKING CHARGES
UK	£2.50 for one tape, add £1.00 for each extra tape you order.
EUROPE	£3.50 for one tape, add £1.00 for each extra tape you order.
REST OF WORLD	£4.00 for one tape, add £1.20 for each extra tape you order.
	Please contact me about having a video made. (no obligation)
	Please contact me about having a website made. (no obligation)
	Please contact me about website design and video production training        courses. (no obligation)

	BILLING
	Payment By Credit Card
	I authorise you to debit my credit card the total sum of   £
	CARD TYPE i.e. Visa, American Express etc.
	CARD NUMBER
	VALID FROM:-                                        MONTH   01 02 03 04 05 06 07 08 09 10 11 12 YEAR  98 99 00 01 02 03 04 05 06 07 08
	EXPIRY DATE:-                                       MONTH   01 02 03 04 05 06 07 08 09 10 11 12 YEAR  98 99 00 01 02 03 04 05 06 07 08 09 10
	CARD HOLDERS NAME
	3-DIGIT SECURITY CODE On the back of your credit card is another code, on or near the signature bar. Please tell us the LAST THREE DIGITS of the code.
	I have enclosed a cheque with my order, made payable to "Quartz Productions".
	(ONLY POUNDS STERLING CHEQUES ACCEPTABLE)
	Please print a copy of this order form and send it to:-
	Quartz Productions
	Offwell
	Honiton
	Devon  EX14 9SW
	United Kingdom
	or fax +44 (0) 1404 831881.   Note credit card orders can only be dispatched to the card holder's address.
	FOR SECURITY REASONS WHEN PAYING BY CREDIT CARD PLEASE FAX OR POST THIS ORDER FORM, DO NOT USE EMAIL. Thank you!

	ADDRESS TO RECEIVE YOUR ORDER
Your Name
Address
Address
Address
City/Town
County/State/Province
Zip/Postal code
Country
Telephone no.
Email Address (e.g. yourname@company.com)
Please include your email address so that we can confirm despatch of your order!