Name:
Email Address:
Address:
City:
State:
Zip:
Phone Number:
How many pictures would you like in your DVD?	50 100 150 200+
What type of Media are the pictures on now?	Photograph CD/ROM Flash Drive Floppy disk Other
If needed please explain:
How many songs would you like? (average 1 song for every 50 pictures)	1 2 3 4
Please list the songs you have in mind: (artist and title)
Do you already have the songs?	Yes No
When will you be needing the DVD completed?
How will N-Genius Solutions be getting the Photo's?	Mail Drop Off Pick Up Other
Explain:
DVD special instructions:

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