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My Story DVD
Traveler Information
*Name of Traveler/Student:
*Address Line 1:
Address Line 2:Apt. or Suite No.
*Zip Code:
*E-Mail of Parent:
*How many DVDs are you purchasing at $15 each?
Credit/Debit Card Information
NOTE: A 3.5% fee imposed by the credit card companies will be added to each card transaction.

Once the payment is invoiced, you will receive a receipt via email.
*Amount to charge today:3.5% will be added
*Card Number:Please put dashes between sets
*Name on Card:
*Expiration Month:
*Expiration Year:
*Card Brand:
By submitting this form, you are agreeing to all terms and conditions. No money is refundable or transferable.
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