Personal Performance Order Form

Dance America Videos

Your Name:

Address:

City:

State:

ZIP Code:

Phone
Number:

Email
Address:

Name of
Performers

Name of
Dance Studio:

NAME/DATE of
Event/Performance:

Type of Dance(s)
Performed:

Name of YOUR
Dance Partner(s):

Total Number of
Personal Performances:

PersonalPerformance DVD Cost:
$25 for 1 Dance; $15 for each
Additional Dance on Same DVD

Amount Due:

.wmv/.mpg File Cost:
$25 per Dance; or $15 per Dance w/Purchase
of related Personal Performance DVD

Total Number of
.wmv/.mpg Files:

Amount Due:

Shipping &
Handling

Total Amount Due:

Please complete and print this form, enclose/attach your
check or money order (payable to Ralph Johnson) for the
appropriate amount, and mail to:

Dance America Videos
Attn: Ralph Johnson
416 James Court
Falls Church, VA 22046

IMPORTANT! So that we may begin processing your
Personal Performance order immediately
(prior to receiving your mailed order and check)
Please click the 'Submit' button below.

You will receive confirmation of your order by email.

Thank you for your order!

Comments:

Kevin Fischer & Mary Botta
At The Promenade
September 18, 2010

West Coast Swing
Flash Mob - Washington, DC
October 16, 2010

Cindy & Cliff
At The Promenade
September 17, 2010

Beverly & Michael Smith
At The Promenade
September 17, 2010

The Twins'
Christmas Eve Program
December 24, 2010

West Coast Swing
Flash Mob - Washington, DC
October 16, 2010

Alaila's Christmas
Program At The Boyd School
December 15, 2010

Sue Wyche
A Dance Memory Video
Comps in 2007 & 2005

Beverly & Michael Smith
At The Promenade
March 25, 2010

Beverly & Peter Tam
At The Promenade
March 26, 2010

MDC 2011 Higlights
March 25-27, 2011

Personal Performance Order Form

In addition to Event Video/DVD sets, we also offer Personal Performance/Memory Videos/DVDs/.wmv/mpg
files of just YOUR dance/performance(s) in Showcase events and in some competitions in other events that we
may Video and edit. DAV can also put your Performance on YouTube!

The cost of your Personal Performance Video/DVD is $25 for the first dance and $15 for each additional dance
in a single event. The Video/DVD will be labeled with a photo of you taken during your performance(s).

Promenade Spring/Fall 2011 Showcase Personal Performance orders will be delivered to The Promenade
unless special mailing/delivery arrangements are made at the time of the order. There is a $8.00 Shipping &
Handling charge for Event and Personal Performance DVD orders 2 weeks after The Promenade's latest event
date(s).

The cost for just the .wmv file of a Personal Performance is $25...if that is all you want....However, if you order a
Personal Performance DVD the cost of the .wmv file would be just $15 for each DVD related performance.
Personal Performance .wmv files will be delivered via email. There are no Shipping & Handling charges for .wmv
file purchases. There is a $10 charge to place your Performance on YouTube.

Please Note: A .wmv (Windows Media Video) file of your performance is small enough to send as an email
attachment...and can also be uploaded to YouTube. However, because of its small/compressed size, the .wmv file
does not have the quality of a Personal Performance DVD or an mpeg2 (.mpg) file.