Dub Request

DVD COPY Request Form

If you would like to purchase a copy of a program that cablecast on NSTV, please fill out the form and return with your check. Checks should be make out to NSTV. You will receive a call when the copy is ready, if you are picking it up. Include $3.00 if DVD is to be mailed. Please allow at least 2 weeks. Questions can be presented to Barbara Morrell at bmorrell@patv.org or (516) 629-3710 Ext. 13
Program Title: *
Episode#/ Topic *
Air Date *

Month Day Year
All DVD copies are $15.00 plus $3.00 S&H
North Shore TV is a Not-for-Profit 501(C)3 Corporation and your donation is tax deductible to the extent that the laws will allow. Thank you for your support
Full Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Phone Number *

Area Code Phone Number
E-mail *
Check this box is you would like to receive more information about NSTV and/or the services we provide to your community
Once form completed, please choose "Print Form" (and make sure your printer orientation is set to "Portrait"). Make check out to NSTV and Mail to: 1111 Marcus Ave., Ste. LL27, Lake Success, NY 11042
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DVD COPY Request Form