Please fill out all the required fields.
Fields marked with * are required.

Your Name: *


Your Email: *


Your Mailing Address, if shipping:


I will be dropping off and picking up my order

Number of photos, slides or negatives to be scanned @$0.30/each *


I would prefer my photos on: *
CD(s)
DVD(s)

MAM-A Gold disc(s) for $1 more/each?

Additional copies of DVD Slideshow on MAM-A silver discs @$5/each


Additional copies of DVD Slideshow on MAM-A gold discs @$6/each


Where did you hear about Disc-Connect?


Special Instructions: