IMPORTANT NOTICE


For credit card and check orders, this form may be mailed to us at the address on the form.

Fax orders will be accepted for credit card orders only.

Please do not attempt to send us credit card information via the internet.  We have no security for credit card transactions at this time.

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Penn Valley Pictures
P.O. Box 429, Sunbury, PA 17801 (570)286-4618
SHIPPING INSTRUCTIONS: 1 ITEM $ 5.00 EACH - EACH ADDITIONAL ITEM $1.00 EACH
PENNSYLVANIA RESIDENTS 6% SALES TAX


24 HOUR PHONE ORDER SERVICE
1-800-577-6003
FAX 1-800-577-6004


QTY

VIDEO TAPE / DVD

PRICE (Per Video)

TOTAL

       
       
       
       


CHARGE ORDERS: Please check card used:
  Mastercard       Visa
Please check preferred media:
  VHS Tape       DVD

                               

We need expiration date and signature to ship your order


Expiration Date

Rectangle Rectangle Rectangle Rectangle

Month

Year

Card Holder's Signature_____________________________________

TOTAL

   

PA SALES TAX 6%

   

SHIPPING

   

TOTAL

   


Name

__________________________

Address

__________________________

City, State, Zip

__________________________

Phone

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