Purchase Order #:
Email:
1
Ordered By
2
Ship To (Fill in only if different from Box 1)
4
Credit Card #1
Exp. Date

Cardholder signature

Order Form

FIRST LIGHT

VIDEO PUBLISHING

2321 Abbot Kinney Blvd., Venice, CA 90291

Order Online: www.firstlightvideo.com

Toll Free: 1-800-262-8862

International: 1-310-577-8581

Fax: 1-310-574-0886

Email:

For orders outside the U.S. call 1-310-577-8581 Monday - Friday, 8:00am - 5:00pm
Pacific Standard Time

8
Volume Discount*

Purchase $500+ Save 5%

Purchase $1,000 Save 10%

*Net 30 Day Terms: University, College, High School, Library & Company Purchase Orders may ship Net 30 day terms. Orders must be submitted by institutional purchase order.

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Payment Method
Check#
Purchase Order #
Charge To:
5
Description
Product Code
Qty.
Title
Unit Price
Total
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Tax Information

If you are tax-exempt, please enter your tax-exempt number and attach a copy of your tax-exempt certificate. Questions? Phone us toll-free at

Check#
7
Digital Rights

If you are tax-exempt, please enter your tax-exempt number and attach a copy of your tax-exempt certificate. Questions? Phone us toll-free at

Subtotal
Shipping & Handling
Less Volume Discount
8.25% CA Sales Tax
GRAND TOTAL