Magnolia Farms Video Service Request Form

Please print off and complete this form, and include it with your video and a postal money order for $10 US for each finished .avi file you require. If you require your original video tape to be returned to you, please include an additional $5 US to cover shipping and handling. Please make money orders payable to:   Jan Anderson, P.O. Box 921, Stephenville, Texas  76401
Your Name:   
Your Postal Address:   
City: 

 
State:   
Zip Code:   
Phone Number:   
Email Address:   

Video Information:
Name of 1st horse:    $10
Comments: 
 
Name of 2nd horse:    $10
Comments: 
 
Name of 3rd horse:    $10
Comments: 
 
Name of 4th horse:    $10
Comments: 
 
Name of 5th horse:    $10
Comments: 
 
Name of 6th horse:    $10
Comments: 
 

Please check here if you want the original video returned: 

 

Shipping and handling cost to return original video, if applicable:

$ 5

Total amount of enclosed money order, at $10 per .avi: 

$

If you have more than 6 horses on this video, please print out and include a second copy of this form with your video.  Mail videos to:
Jan Anderson, P.O. Box 921, Stephenville, Texas  76401