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Town of Freeport
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VIDEO REQUEST SUBMISSION FORM

Please fill out this form to request video from our TV department.
*Your Full Name: 
*Your Email Address: 
*Phone Number: 
*I prefer to communicate via: 
Email
Phone
*What video(s) would you like to request? In your description below include the event and the date the event took place: 
*Choose a viewing medium: 
VHS Video Tape $30
DVD-R (playable in newer DVD players) $20
Please include any additional information you would like us to recieve before we process your request and contact you: 
*Form Security: 
Please enter the text that appears below: