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  1. ReelMotion™ Version 1.0 Order Form
  2.  
  3.  
  4. Copies __________ x $795.00 U.S. = _______________ 
  5.  
  6. Residents of Virginia add 4.5% Sales Tax _________
  7.  
  8. Shipping:
  9.  
  10. Check One: 
  11.  
  12. ___ Inside the U.S. - Postal Service    $5.00_____
  13.  
  14. ___ Inside the U.S. - 2 Business Days   $10.00    
  15.  
  16. ___ Inside the U.S. - Next Business Day $20.00    
  17.  
  18. ___ International   - 2 Business Days   $40.00    
  19.  
  20.            
  21. Total ____________________________________________
  22.  
  23.  
  24. Shipping Address:
  25.  
  26. Name: ____________________________________________
  27.  
  28. Company: _________________________________________
  29.  
  30. Address:__________________________________________
  31.  
  32.         __________________________________________
  33.  
  34. City: _____________ Prov/State: __________________
  35.  
  36. Zip/Postal Code: _________________________________
  37.  
  38. Phone: ___________________________________________
  39.  
  40. Fax: _____________________________________________
  41.  
  42. Email: ___________________________________________
  43.  
  44.  
  45. Method of Payment:
  46.  
  47. Check One:
  48.  
  49. ___ VISA
  50.  
  51. ___ MasterCard 
  52.  
  53. ___ American Express
  54.  
  55. Card Number: _____________________________________
  56.  
  57. Expiry Date: _____________________________________ 
  58.  
  59.  
  60. Billing Address (if different from shipping address):
  61.  
  62. Name: ____________________________________________
  63.  
  64. Address:__________________________________________
  65.  
  66.         __________________________________________
  67.  
  68. City: _____________ Prov/State: __________________
  69.  
  70. Zip/Postal Code: _________________________________
  71.  
  72.  
  73. Please complete this form and e-mail it to:
  74.  
  75. info@reelmotion.com
  76.  
  77. Thank you for purchasing ReelMotion. Should you have 
  78. any questions, please do not hesitate to call.
  79.