Request for Media Digitization

Information About You

Your name:

Your email address:

Your postal address (no apostrophes please):

Name of your mission agency (alphabetic characters only, please):

Email address of your mission:

Postal address of your mission (no apostrophes please):

The services your require

Audio Tapes:

Photographic slides or negatives:

VHS Video Tapes:

What else do we need to know about this?

What arrangements will you make for payment?

(This will be to cover the cost of CDs, DVDs and postage.)

Please type the characters displayed on the left into the box on the right. All alphabetical characters are shown in uppercase but you may type them as lowercase. The number zero is indicated with a diagonal line whilst the letter O is clear inside.

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