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New Client Request Form

      Please provide as much information as possible.

Select all the services

that apply to this client.

                                >>>>
Audio Video Recording Packages
Starter Package (CD's)-$99.00/mo
Standard Package (CD's)-$199.99/mo
Video Standard Package (DVD's)-$299.99/mo
A/V Deluxe Package (CD's & DVD's)-$399.99/mo
Editing Preferences
Provide intro and exit text here. Indicate if any portion of the broadcast should be removed.
Audio Video Live Streaming Packages
Audio Standard Package-$99.00/mo
Radio Station-$399.99/mo
Video Day Package-$499.99/mo
Video Standard Package-$549.99/mo
Television Station-$1,249.99/mo
 Web Site Design Packages
Basic Package (Stand Alone)-$149.99
Deluxe Package-$299.99
Custom Design Package-$ TBD
HCI Hosting Plan-$12.95/mo
Domain Name-$20.00/year
Audio Video On Demand Packages
Audio On Demand-$99.99/mo
Video On Demand-$249.99/mo
Video On Demand (Edited)-$799.99/mo
Specials
Special Introductory Offer-$599.99/mo
Website Basic Package (Part of ISO)-$0.00
Holiday Special-$350.00/mo
Organization’s Contact Information:
*Name of Organization
Street Address
City State   Zip Code
Main Phone Number
( )   - Ext.

Name of Authorized

Contact Person

Authorized Person's Title

Authorized  Person's

Phone Number
( )   - Ext.

*Authorized Person's

Email Address

 *Verify Authorized Person's Email
Organization’s Technical Contact Information:

Technical Contact

Person's Name
 
This may be the Media Director or Sound Technician. Information is needed to schedule the installation and sound check.
Technical Person's Phone
( )   - Ext.

Technical Contact  

Person's Email Address

 *Verify Technical Person's Email
PA System Provide the client's model of their PA system, or mixing board Router Code (For Streaming) If you client has a wireless router with a security code, please insert information here.
Shipping Address
City State   Zip
Player Platform Information:

Broadcast Times

 Example - Morning Worship Services, Sundays at 11:00 AM EST

1000 characters remaining.(Live Streaming) For each event, list the following: -- Name of Program -- Day of the week -- Time of event with time zone
Graphic Assistance? Indicate

Yes

No

Other

Upload Files/Graphics
Select up to 10 files (one at a time) and and click 'Add':

File(s) selected for upload:


Organization's Billing Information:
Billing Contact Person

Billing Person's Phone

( )   - Ext.
      Billing Person's Email
     
*Verify Billing Person's Email
Payment Due Date
1st of the month 15th of the month