Please complete this section and sign rental agreement if you are renting videos
Title
Show Date
Fee
______________________________________________
_________
______
______________________________________________
_________
______
______________________________________________
_________
______
______________________________________________
_________
______
______________________________________________
_________
______
______________________________________________
_________
______
______________________________________________
_________
______
Price Subtotal: __________________
Rental Agreement
To keep rental and purchase prices as reasonable as possible, it is the Family Center’s policy not to permit previewing, since each use of the video shortens its life. However, if you are planning to purchase a video, you may pay the rental fee for the video to preview it. The rental fee will be deducted from the purchase price if you decide to buy the video. Clinical videos may only be rented.
Please order at least three weeks prior to the desired showing date.
This rental agreement must be signed and returned to the Bowen Center before videos will be released. Please fax to (202) 965-1765.
Clinical videos will be shown only to professional audiences and the confidentiality of the families on the tapes will be protected.
Videos will not be reproduced in any manner (including sound track reproduction). The Family Center videos are copyrighted. Any reproduction of material in them is a violation of copyright law.
Videos will be played on machines in good working condition so they will not be damaged.
Videos will be used for one showing only, and will be returned promptly after use, insured for $200.
_____ I agree to the above rental terms.
Signature:_______________________________________
Date:___________________
Shipping and Handling
US Priority Mail
Federal Express Please call us for exact rates.
United States:
10% of total order
United States:
$ 25.00+
Canada and Mexico:
15% of total order
Canada and Mexico:
$ 35.00+
Outside North America:
Fed Ex only
Outside North America:
$ 50.00+
Shipping and Handling: __________________________
TOTAL AMOUNT DUE: __________________________
Please allow two weeks delivery.
Payment
Payment is due with the order. Please pay by check or credit card. Make checks payable to The Bowen Center. Outside the US, credit card only, please.
Type of card (please circle): Visa / Mastercard
___________________________
____________
___________________________
Credit Card Number
Expiration Date
Signature
Bill to:
Name: _________________________________________________
Organization: ___________________________________________
Address: ___________________________________________________
City, State, Zip, Country: ______________________________________
Daytime Phone: _____________________
E-mail: _________________________
Check if mailing address is same as billing address
Send to:
Name: _________________________________________________
Organization: ___________________________________________
Address: ____________________________________________________
City, State, Zip, Country: _______________________________________
Daytime Phone: _____________________
E-mail: _________________________
If you have questions about your order, please contact Kathy Vlahos at 202-965-4400 x 23 or kvlahos@thebowencenter.org.