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3. 
5. Video Services
   Dub Request
9. A fee is required for all external DVD dub requests. The fee is fifteen dollars ($15.00) per copy. Make checks payable to “Treasurer, County of York”. Video Services reserves the right to assess additional fees if multiple programs are requested on one DVD. DVDs will be completed as time permits and on a first-come, first-serve basis, unless otherwise noted. DVDs must be picked-up within 30 days of notification of completion.
13. Name:*
14. Date of Request:*
    Date of Request:
16. Address:*
18. City:*
19. State:*
20. Zip Code:*
22. Daytime Phone Number:*
23. Department/Division (if applicable):
25. Program Requested:*
26. Number of Copies:*
Leave This Blank:


28. 1. Receive an email copy of this form.
29. Email address

    This field is not part of the form submission.

30. Submit

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