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Your Name: *


Your Email: *


Your Mailing Address, if shipping:


I will be dropping off and picking up my order

Number of Videotapes for conversion @$12/each: *


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

Additional copies of non-copyrighted tapes on MAM-A silver-plus discs @$6/each


Additional copies of non-copyrighted tapes on MAM-A archival gold discs @$7/each


[Optional] Number for additional conversion to compressed format @$5/each:


Compressed Format (if applicable):
N/A Video iPod - 320x240 Video iPod - 640x480 PSP Tivo AVI DV MPEG WMV Flash Video

Where did you hear about Disc-Connect?


Special Instructions: