Verge Video Productions 6915 Thrasher Drive - Tampa, FL 33610
Navarasa Performing Arts Academy
Video/Photo Order Form
Price:
Video=$35.00; Photo=$25.00; Both =$50.00
Name
______________________
Address
______________________
______________________
Phone
_______________________
Email
_______________________
# of Video
DVDs @ $35.00ea.____
# of Photo
Discs @ $25.00ea.____
# of Photo +
Video@ $50.00ea.____
___ Check
here if you wish to pick up your purchase at the studio.
____ Check
here and add $5.00 to have your purchase mailed.
Check
#_______ Cash____
(Sales Agent’s Initials)
Make checks payable to: Verge Video Productions.