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RAVEN Digital Video CD Request Form

CLIP ORDER NO: 1268307369

Store Information
Company
Store #
Name of person requesting Clip
Title
Store Address Line 1
Store Address Line 2
City
State
Zip
Phone
Today's Date

Clip Information

Due to the nature of remotely retrieving recorded video, please limit clip requests to one camera and up to one hour.

Requests in excess of these guidelines, or requests placed after 2:00pm EST may take an additional day or more to process and may incur additional charges.
Date
Begin Time : AM PM
End Time : AM PM This clip goes past midnight
Camera Needed
Event you are looking for
Number of CD copies
The first copy of a CD is included in the price. Each additional copy costs $5.00. Please specify how many CD copies you would like in the box above.

Ship To Address
Same as above
Ship To Name
Ship To Address Line 1
Ship To Address Line 2
Ship To City
Ship To State
Ship To Zip
Ship To Phone

Shipping Options

PLEASE NOTE: For security purposes and to maintain the integrity of your video, RAVEN Clip Discs will no longer be shipped via U.S. Mail. All RAVEN Clip Discs will be shipped via trackable delivery.
FedEx Ground Delivery ($7.95)
FedEx 2nd Day Delivery ($12.75)
FedEx Standard Overnight ($20)

FedEx Overnight Delivery for Saturday ($55)*

Delivery charges will be billed to the
location's account.

Signature
As your online signature, you MUST reenter the following information:
Your Name
Your Title
Your Email Address

Cost
CD Cost
Shipping Cost
Total Cost
 
For questions or additional information please contact UAS IT at 800-421-6661.

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