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    Video Rental Application Form
     for Organizations Not Affiliated with the NRHS

    Organization Information

     Name:
    Street Address:
    City:
    State/Province:
    Zip/Postal Code:
    Country:
    Daytime Telephone:

    Your Information

    Your Name:
    Your Title:
    Your Daytime Telephone:
    Your e-mail Address:
    Shipping Information
    Street Address:
    City:
    State/Province:
    Zip/Postal Code:
    Country:
    Instructions:
    1. A maximum of three videos may be rented by a Chapter at one time.
    2. Rental applications should be mailed at least one month in advance of the date you wish to have the film.
    3. Please list alternate titles in the event the titles you wish to have are not available on the date you requested. LIST TITLE IN THE ORDER IN WHICH YOU DESIRE THEM.
    4. For U.S. addresses the rental fee, including one-way shipping to your organization, the rental fee is $10.00 per tape.
    5. For international rentals, you must contact us before sending in this rental application to determine the rental charge.
    6. Please return videos within 14 days of their receipt.
    7. You must include full payment with your rental application.  Make your check or money order payable to National Railway Historical Society.  All fees are in U.S. Dollars.
    8. If you need further assistance in booking a program, please contact the National Office at 215-557-6606 (fax 215-557-6740) between 9:00 AM and 4:00 PM Eastern Time weekdays or send an e-mail to services@nrhs.com .

     

    Please mail your order to:
    National Railway Historical Society
    P.O. Box 58547
    Philadelphia, PA 19102-8547

    Make your check or money order payable to:
    National Railway Historical Society

     
    FBI WARNING: U.S. Federal law provides severe civil and criminal penalties for the unauthorized reproduction of copyrighted videotapes (Title 17, United States Code, Section 501 to 506). The FBI investigates allegations of criminal copyright  infringement. THESE TAPES MAY NOT BE REPRODUCED IN ANY WAY BY RENTERS.
    Video
    Number      		 Title Date
    Desired
    (mm    /dd/yyyy)
    1. _____ ___________________________ ________
    2. _____ ___________________________ ________
    3. _____ ___________________________ ________
    Alternate Selections
    1. _____ ___________________________ ________
    2. _____ ___________________________ ________

     

    Total Rental Fees Enclosed for U.S. Addresses
    ($10.00 x number of tapes requested)    :   $ ________

    Total Rental Fees Enclosed for International Addresses
    (contact us for charges)    :       $ ________

     
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