Name:

Email:

Address:

City:

State:

Zip:

Phone (Day):

Phone (Night):

Is this a surprise for someone that might answer a phone # above?  Yes

Number of photos in Digital format (already scanned):

Number of photos in Paper format (we will scan):

DVD Format (aspect ratio): ---Standard TV (4:3)Widescreen (16:9)

Additional DVD Copies:

Would you like your scanned photos on a CD for printing and sharing?  Yes

Main Title for DVD (title displayed on main menu and disc label):

Photo # for DVD menu background:

Chapters - List DVD menu chapter names and picture #'s belonging to each (i.e. Childhood 1-10, Teen Years 11-20, Adulthood 21-30):

Chapter 1 text: Photo #'s:

Chapter 2 text: Photo #'s:

Chapter 3 text: Photo #'s:

Chapter 4 text: Photo #'s:

Have more Chapters? List them below:

Title Slides - Use title slides to make an introduction or give more information about upcoming photos (i.e. "Julie's First Birthday!" or "The Early Years"):

Title Slide 1: Before Photo #

Title Slide 2: Before Photo #

Title Slide 3: Before Photo #

Title Slide 4: Before Photo #

Have more Title Slides? List them below:

Captions - Captions are text shown on top of a photo being shown (i.e. "1917-2003"):

Caption 1: On Photo #

Caption 2: On Photo #

Caption 3: On Photo #

Caption 4: On Photo #

Have more Captions? List them below:

Transitions and Special Effects - Select the transitions between each photo as well as any special effects. See Demo Page for examples and names of current transition/special effects:

Transitions: Standard FadingOther, enter name to the right:

Special Effects:

Music and Video - Roughly one song per 30-40 pictures syncs up well. If a song is too long for photos, it will be faded out. Videos must be less than 3 minutes in length and either .mpg, .mpeg or .avi file types:

Song Title/Artist 1: During Photo #'s:

Song Title/Artist 2: During Photo #'s:

Song Title/Artist 3: During Photo #'s:

Song Title/Artist 4: During Photo #'s:

Have more Songs? List them below:

Do we need to purchase any of these songs for you?  Yes

Video 1: Before Photo #

Have more Videos? List them below:

May we use clips of your finished slide show for demos/examples of our services?  Yes

Additional information or instructions:

"Undersigned" refers to person named in "Name:" field above. All materials submitted to DVD Memoree on this order are my personal property and I acknowledge and agree that DVD Memoree or its agents shall not be liable for any loss or damage, direct, consequential or incidental arising out of customer's use of DVD Memoree's services. The undersigned hereby warrants that the materials presented to DVD Memoree or its agents for transfer are not to his/her knowledge protected by copyrights, or if the material is protected the undersigned has obtained the permission of the copyright owner to make or have DVD Memoree make copies of the material, and that such permission is in written form and in the possession of the undersigned. The undersigned hereby warrants that this order is to be used exclusively for private use and will not be commercially distributed. The undersigned will hold DVD Memoree harmless for any expenses that might arise by the reason of any infringement of copyright related to this order. The undersigned has read and agrees to the DVD Memoree Terms of Service located at www.dvdmemoree.com/tos.

I have read and agree to the above: