Ken Allen Video
3784 Grove Avenue
Palo Alto, CA 94303
ken@kenallen.tv
To:
Name:____________________________________________
Address:____________________________________________
City,
ST Zip:____________________________________________
Media Mail
Videotape/DVD Order and Mailing Label
Your
phone:_______________________
Your
email:________________________
PROGRAM
NAME:__________________________________________________
Date of performance or
production(optional):___________
#_____ tapes @ $23.80ea+$2.20
(9.25%) sales tax@$26.00 = ________ Subtotal
#_____ DVDs @ $19.22ea+$1.78
(9.25%) sales tax@$21.00 = ________ Subtotal
+_____ Program over two
hours
ADD $ 5.00 = ________
+_____ delivered or
mailed
ADD $ 5.00 = ________
_____ Pickup (Free)
================
________ Total
Santa Clara County sales tax charged on all sales.
(Some programs are
subject to restriction.)
Make checks payable to
Ken Allen.
Phone: (650) 494-8868
Email ken@kenallen.tv