CLIP REQUEST FORM

Use the form below to request a clip from UAS. Complete all available fields.

Form ID

Store Information

Company *

Title *

Name of person requesting clip *

Store Number *

Store Address *

City *

State *

Zip *

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.

Clip Date Start *

Month

Day

Year

Start Time *

Hour

Minute

Clip Date End *

Month

Day

Year

End Time *

Hour

Minute

Cameras Needed

Please enter the specific camera names in the fields below. Enter one (1) camera per field.

Camera 1 *

Camera 2

Camera 3

Camera 4

Camera 5

Camera 6

Camera 7

Camera 8

Camera 9

Camera 10

Camera 11

Camera 12

Camera 13

Camera 14

Camera 15

Camera 16

Describe event you are looking for *

Number of Copies *

The first copy of a CD is included in the price. Each additional copy costs $5.00.

Ship-To Address

Ship To Name *

Ship To Address *

Ship To City *

Ship To State *

Ship To Zip *

Ship To Phone *

Ship To Email *

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.

Select Shipping Option

FedEx Ground Delivery ($7.95)

FedEx 2nd Day Delivery ($12.75)

FedEx Standard Overnight ($20)

FedEx Overnight Delivery for Saturday ($55)

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 $

Search form

You are here

CLIP REQUEST FORM