Customer E-Mail
Important: Enter a valid e-mail address. Receipts will be sent to this address.
*E-Mail:  
Birdseye Sports DVD Store Order Form
2009-2014  
Ski Sundown  
2010 -2011 Playoffs  
2008-2011 Regular Season Games  
2007 Games  
Customized Video  
Team Game Film (Coaches)  
Team Game Film (Player)  
Sub-Total:  
Tax (CT 6.00%):  
Shipping & Handling:  
Grand Total:  
Billing Information
*First Name:   Same name as on your card
Middle Initial:  
*Last Name:  
*Address Line 1:   Where your statement is mailed
Address Line 2:   Apt. or Suite No.
*City:  
*State:  
*Zip Code:  
*Phone:  
Shipping Information
Same As Billing Info  
First Name:  
Middle Initial:  
Last Name:  
Address Line 1:  
Address Line 2:  
City:  
State:  
Zip Code:  
Credit/Debit Card Information
*Card Number:   No dashes or spaces please
*Expiration Month:   From your card
*Expiration Year:   From your card
*Card Brand:  
CVV:   Card Security Code


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