Video Order Form

To order your video, fill out the information below, Click Submit and Click the link to make your payment using your Credit/Debit Card (Visa Or Master Card) or you may click the link to print out the order form and mail with your payment to the address listed below.  Do Not mail cash.  Make Checks payable to Carolina Productions.

You can have your DVD mailed to you by adding an additional $5.00.  Arrangement for pick can be made at a designated location.  You will be notified when your order is ready to pick up or to be mailed.  If you have any questions regarding your order or how to proceed with your order, please call 336-597-4446 or E-mail to carolinavideodj@aol.com.  

NOTE:  All Videos are digitally encoded to prevent unauthorized coping.  Any attempt to copy may result in permanent damage to your video and will not be refunded. 

 

Name of Show:

Name of Show

Show Date:

-- mm/dd/yy

Please provide the following contact and mailing information:

Name
Street Address
Mail Address 
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail

How many Copies


Choose one of the following options:

Mail order directly to address above (add $5.00)
Pick Up Order (at a designated location)

Payment Total

$

Carolina Productions & Entertainment ~ 105 North Main St., Suite 104 ~ Roxboro, NC 27573   336-597-4446 ~ 919-787-3200
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John R. Williford.
Copyright © 2007 [Carolina Productions & Entertainment]. All rights reserved.
Revised: April 01, 2008