To participate in the EZ-D™ incentive program, please:

  1. Print this form.
  2. Fill in the blanks on the printed form (phone number and email address are required).
  3. Circle one title from the Eligible Titles list as your selected free title.
  4. Mail this form, along with your six used EZ-D™ discs, to:

    Buena Vista Home Entertainment
    Attn.: EZ-D™ Incentive Program
    800 Winneconne Avenue
    Neenah, WI 54956


Name


Street Address


E-mail


City


State


Zip


Phone Number

ELIGIBLE TITLES (please CIRCLE ONE from the list below)
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