V i d e o   O r d e r   F o r m
	    
	    
Please Print


Event:


Date:


Number of DVD copies _____       Number of VHS Tape copies _____


Name:


Address:


City/State/Zip:


Phone:



Include a check for $15.00 payable to: Bolingbrook Community Television

Mail to: Bolingbrook Community Television
 	 375 W. Briarcliff Road
	 Bolingbrook, IL 60440
 	 Attn: Video Order

Or bring to the Bolingbrook Village Hall Financial Window during regular business hours. Tapes will be mailed to your home. Please allow at least 3 weeks for delivery.


_______________________________________________________________________________


	    V i d e o   O r d e r   F o r m
	    
	    
Please Print


Event:


Date:


Number of DVD copies _____       Number of VHS Tape copies _____


Name:


Address:


City/State/Zip:


Phone:



Include a check for $15.00 payable to: Bolingbrook Community Television

Mail to: Bolingbrook Community Television
 	 375 W. Briarcliff Road
	 Bolingbrook, IL 60440
 	 Attn: Video order

Or bring to the Bolingbrook Village Hall Financial Window during regular business hours. Tapes will be mailed to your home. Please allow at least 3 weeks for delivery.