Order A Clip From Worldwide News Monitor Contact Information Name: Business: Address 1: Address 2: City: State: Zip: Daytime Phone: Alternate Phone: E-mail: How do you prefer to be contacted? Phone E-mail What Are you Looking For? (Please fill out all available information) Program Name: Station: Date: Time: Other Information: How would you like the clip delivered? VHS Tape S-VHS Tape DVD CD-ROM* E-mail* On the Web* *customer must be responsible for having proper software to play electronic clips on the computer, like QuickTime, RealPlayer and Windows MediaPlayer. PO # Other Information or Comments: