DVD mail order form
DVD description:
1.
2.
3.
Customer information:
| Prefix | First Name | Last Name |
Address
City
Postal/zip code
Country
Telephone
Fax
Mills Video Productions
4979 W. 13th Street
Speedway, IN 46224
Phone: (317) 508 - 0655
E-mail: mvpvdo@aol.com
