Fill In this order form, print it, and send it with your order. Use the shipping labels on the bottom of this form for your convenience.
Thank You!

Integrated Imaging
1743 East 2nd Street
Casper, WY 82601
307-266-3805 ~ 1-800-780-3805
www.iilabs.com

Name:  
Address:  
  
City:  
State:      Zip: 
Ground Shipping ($10.00 - $25.00) E-mail:  
3 Day Air (add $15.00 to ground price) Phone:  
2 Day Air (add $25.00 to ground price) Number of tapes sent
Next Day Air (add $45.00 to ground price) Choose DVD Option (price each)
Other Instructions: Mastered DVD $150.00 1 hour mode (highest quality)
Mastered DVD $150.00 2 hour mode
Recorded DVD $29.95 1 hour mode (highest quality)
Recorded DVD $29.95 2 hour mode
Title for DVD case:
Additional VHS copies of each DVD $19.95 Each
Additional DVD copies of each DVD $14.95 Each
 Payment Information:
 
Card Type:     Card Number:    CVV Code:  
 Expires:    Name On Card:  
 Signature:______________________________________________________________________
Email me with a total and I'll send a check or give the card # Over the Phone
We also have a secure server for your online convenience. Check here and we will e-mail you with the total amount and you can submit payments online at: https://www.iilabs.com/pay/
Shipping Label Office use:
Originals
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Total __________
Format: _________________ Total __________
Duplicates   __________
Number Type Cost each Total __________
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Other fees ______________________ __________
Shipping and Handling fees: __________
Total for Transfer: __________