Video Services Dub Request

Video Services Dub Request
A fee is required for all external USB flash drive requests. The fee is fifteen dollars($15.00) per copy. Make checks payable to "Treasurer, County of York". Video Services reserves the right to assess additional fees if multiple programs are requested on one external flash drive.

Mail your check with this completed form to:

York County Public Affairs
P.O. Box 532
Yorktown, VA 23690

USB flash drives will be completed as time permits and on a first-come, first-service basis, unless otherwise noted.

USB Flash drives must be picked up within 30 days of notificaiton of completion at the Public Affairs office, 224 Ballard Street, Yorktown, VA 23690.
Date of Request:

MonthDayYear
Date
Name:

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Daytime Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Department/Division (if applicable)
Program Requested:
Number of Copies:
Amount you will be enclosing:
Should be Empty: