SHOKUS VIDEO
ORDER FORM

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SHIP TO:

Name

Address

City State Country (if not USA)

Zip or Postal Code

e-Mail Address

(Required if you want order confirmation)


Voice Telephone Number Fax

METHOD OF PAYMENT

Please select one:

    Visa
    Mastercard
    Discover
    American Express

    Please send a Pay Pal Invoice. (Your e-mail address above must match your Pay Pal account)
Card No. Exp. Date

IMPORTANT: Please make sure if you are using a Visa, Mastercard, or Discover Card that you indicate FOUR (4) sets of numbers for your card number above. Amex accounts have three (3) sets. We must have complete credit card account information before we can process your order.

Note: If you wish to pay by check, money order, or via fax, see the bottom of this page for information.

TITLES REQUESTED

QuantityPgm #
Title
VHS/DVD
Price

Subtotal..................................................................................

Overseas customers: If you want your tapes in PAL or SECAM, please add $10.00 per tape, and type VHS-PAL or VHS-SEC in the VHS/DVD column above. DVDs are not available in PAL/SECAM, but are not region-encoded, so if you have a multi-system DVD player that accepts DVD-R, our discs should play back.

SHIPPING CHARGES

All tapes are shipped via PRIORITY MAIL only within the United States unless otherwise requested. Please add the appropriate amount below to your order. These rates reflect the postal rates that went into effect on 1/7/06, and are computed from the amounts based on shipping VHS tapes from California to the east coast. These rates will be adjusted downward if you live closer than the east coast to California or if you are ordering DVDs only, since they weigh less. A revised total will be sent in your e-mail confirmation when we ship your order. If you want your order shipped via UPS or Federal Express, please type either UPS Grnd., UPS 2nd Day, Fedex Pri or Fedex Stan in the space below. Orders outside the US are shipped via Air Mail, and the price varies depending upon the country. When we send an e-mail confirmation to you, we will quote you what we will charge you based on the the current rate. For now, please type Air Mail in the space if you are ordering outside of the U.S.

1 title: $4.60

2 or 3 titles: $7.50

4 or 5 titles: $10.55

6 or 7 titles: $13.45

8 or more titles: $15.85


FINAL CALCULATIONS


Subtotal, once again...........................................................

CA residents please add 8.25% sales tax ..........................

Shipping Charge.................................................................

Final Total..........................................................................

Please enter any special instructions below. We'd also like to know how you found us - what brought you here from wherever you happened to be. If you used a search engine, please specify which one, and the keywords you used. Thanks a lot!

Thank you for your patronage! We will e-mail you back a confirmation letting you know exactly when your order has shipped. Note: If you wish to pay by check or money order through the U.S. Mail, you may still fill out and e-mail this form to us, but please type in the special instructions box, "Please hold order - will be sending payment by U.S. Mail." Then send your order to SHOKUS VIDEO, P.O. BOX 3125, CHATSWORTH, CA 91313. For your convenience, you may also fax your order to us at (818) 701-0560. Please include your credit card account number and expiration date.

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