Ken Allen Video
3784 Grove Avenue
Palo Alto, CA  94303-4536
ken@kenallen.tv

                                To:          Name:___________________________________________

                                           Address:___________________________________________

                                      City, ST Zip:___________________________________________

Media Mail

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                                      Video Order

 Your name:______________________________________’

      Address:______________________________________

City, ST ZIP: ______________________________________

Your phone:______________________________________

  Your email:______________________________________
                                                                  

PROGRAM NAME/DESCRIPTION_____________________________________________________

  Date of performance or production (optional):___________
(Some programs are subject to restriction.)


#_____ DVDs ($18.39ea+$2.01 (8.75% tax)                             @$20.00=  ________ Subtotal
#_____ Std Blue Ray Disc ($27.59ea+$2.41 (8.75% tax)        @$30.00=  ________ Subtotal
#_____ DVD DL @ $22.99ea+$2.01 (8.75% tax)                      @$25.00=  ________ Subtotal

+_____ Delivered or mailed                                                  ADD $5.00= ________
Subtotal
  _____ Pickup (Free)
                                                                                                                  ================
 
                                                                                                                             ________ Total

                          Other formats: Email or Call/Text 650-776-6392
                  Make checks payable to Ken Allen or use PayPal @ ken@kenallen.tv