Ynez Violé O’Neill
Academic Video Purchase Form

(For use in snail-mail only)

 


Please return with check payable to the Ynez Violé O'Neill.

Video Title: _________________________________________________________


(California residents please add sales tax of 8.25%)


Processing and reproduction fees: $85.00 :____________

Name: _______________________________________

Address: ______________________________________

_______________________________________________

 

Send to:

Professor Ynez Viole O'Neill
Medical History Division
Department of Neurobiology
UCLA School of Medicine
10833 Le Conte Ave.
Los Angeles CA 90095-1763

 

(also available in SECAM or PAL version upon request at the additional cost of $20.00 for a total cost of $100.00)