City of Hampton - Channel 47 - Video Request Form

Video Request Form

Channel 47 City of Hampton
Video Request Form

Date of Request:

Name:

Address:

City/State/Zip Code:

Daytime Phone Number:

Home Phone Number:

Cell Phone Number:

City Department/Division(if applicable):

Program Requested:

Please Check: VHS or DVD requested

Number of Copies:

Tape Provided: YES NO

Amount Paid:

Check #:

A fee is required for all external dub requests. For clients providing their own new VHS tape, the fee is ten dollars ($10.00) per copy. For all others, the fee is fifteen dollars ($15.00) per copy. For each additional VHS tape required to complete the dub, there is an additional ten dollar ($10.00) fee. For DVD copies, there is a flat fee of twenty dollars ($20.00). For each additional DVD required to complete the dub, there is an additional fee of ten dollars ($10.00). Channel 47 reserves the right to assess additional fees if multiple programs are requested on one tape.
Make checks payable to "City of Hampton", send this completed form and check to:

Channel 47 Studio
418 West Mercury Boulevard
Hampton, Virginia 23666

DVD´s will be completed as time permits and on a first-come, first-serve basis, unless otherwise noted. All dub requests must be picked up within 30 days of notification of completion at the address above. Questions? Call Channel 47 Office, 727-5200 or 727-2502.

Channel 47 City of Hampton Video Request Form

Channel 47 City of Hampton
Video Request Form