WheelerArts 3-D Slide Scanning OrderForm 2021B Print this order form and fill in completely. Send with stereo slides and instruction list to: Wheeler Arts, Stereo Slide Scan Dept, 66 Chestnut Court, Champaign, IL 61822 USA
Package your slides securely (we suggest insuring them).
. Name ____________________________________________________________________ . ~ Company ____________________________________________________________________ . Street Address ____________________________________________________________________ . City, State, Zip _______________________________________________________________ (USA) . Phone ______________________________________ . E-mail ____________________________________________ for order shipment notification
. Set-up Fee: $30 for 1-49 scans, $40 for 50-99 scans, $50 for 100 or more scans (per order, includes first disc set) $ _____________ (Check size) 4" , 6" , 8" , 11 " : number of Singles _____ x $_______ per Left or Right window scan = $ _____________ . (Check size) 4" , 6" , 8" , 11 " : number of Pairs _____ x $_______ per Left & Right window scans = $ _____________
~ Chemical cleaning ______ x $12 per window = $ _____________ . ~ Duplicate sets: ______ additional disc copy/copies x $10 = $ _____________ . ~ USB Flash Drive: ______ copy/copies x $10 = $ _____________ . Subtotal = $ _____________
. ~ Rush fee (see rates below) $ _____________ . ~ Repeat Discount (save 10% of subtotal above) / Your last order/receipt #_________ $ -____________ . ~ Special Discount (save ___% of subtotal above) / Special code #_________ $ -____________
. S&H for disc(s) & returning slides to USA address ($15 Ground, $25 Air or Priority) $ _____________ . ~ Postal insurance (add $1 per $100 value on returned slides) $ _____________ .
TOTAL (US funds) = $ ____________ . Thank you!
Payment: Check enclosed, payable to Wheeler Arts (sorry, Money Order not accepted). PayPal. Your eMail address_____________________________ (as listed on your PayPal account for invoicing).
Required: I/we, (print name/names)______________________________________________________, am/are legal owner/owners of the enclosed slides and grant Wheeler Arts permission to scan them. I/we retain all rights to the slides, their scans, and those images. Wheeler Arts will not release such slides, their scans, or copies to another party. . Signature(s): ______________________________________________________ Date: ______________
I have numbered the enclosed slides and included a corresponding list of scanning instructions. Number of slides: ____. . Windows to be scanned (check one): ___All pairs, ___All left, ___All right, ___Other per my instructions / list attached . Media (check one disc format): ___CD, ___DVD . Total number of disc sets: ___
Contact: Ph 217.359.6816 (Please leave a message and we will return your call within 48 hours, 10AM-2PM, Mon-Fri, IL time. Closed August, December 15 - January 15, and Holidays.
Discounts:
If you purchased scans during the past 12 months of $500 (subtotal) or greater, Save 10% now. Fill in your latest scan order/receipt number on the "Repeat Discount" line of the order form above.
If you received a discount via our E-mail, Save now. Valid for limited time. Fill in special code number and its savings amount on the "Special Discount" line of the order form above.