Documentary Showcase - Independent Film and Video - Order Form



Thank You for Ordering

Please click inside this frame and print-out two copies of this page. Fill in necessary information and mail one copy to us along with your check or money order totaling $24.95 - no shipping charges. Keep the duplicate copy for your personal records.

NAME OF VIDEO:

YOUR FULL NAME:

YOUR ADDRESS:

YOUR PHONE:


PLEASE MAIL YOUR ORDER TO:

VIRTUAL WHOLESALE, INC.
10615 Gurney Road
Baton Rouge, LA
70714

To Contact Us Click Below:

staff@humanitas-international.org