Blinkinc Order Form -Valid in Europe, Africa and the Middle East
Please print and complete this order form, then fax to Blinkinc on 1-804-784-2357 or post to:
Blinkinc, P.O. Box 29858, Richmond, Virginia 23242, U.S.A.

Name:
Company:
Address 1: (no P.O. Boxes please)
Address 2:
City: Region: Postcode:
Country: Tel: Fax:
What magazine or advertisement prompted you to place this order?
Email Address:
Product List Price Offer Price Quantity Amount
DeltaPatch 1.2- Save $50! $345 $295 _______ _______
Shrinker 3.5 - Save $30! $225 $195 _______ _______
NOVLIB 3.3 - Save $50 $345 $295 _______ _______
Blinker 7.0 - Save $50! $345 $295 _______ _______
Blinker 7.0 Upgrade   Only $175 _______ _______
Shrinker 3.5 Upgrade   Only $95 _______ _______
NOVLIB 3.3 Upgrade   Only $175 _______ _______
Shipping & Handling: EC countries $35, All other countries $50     S + H: _______
      Total: _______

Include serial number(s) below for all upgrade orders

Shrinker S . - . . . . . .
NOVLIB N . - . . . . . .
Blinker . R - . . . . . .

Method of Payment

Please note: No checks will be cashed or credit cards debited until your order ships.

__ Cheque enclosed (Must be drawn on U.S dollar account and payable to Blinkinc.)
__MasterCard __ VISA __AMEX Expiration Date:_____/_____
Card# . . . . . . . . . . . . . . . .

Card holder name and billing address (please print):

Name:
Company:
Address:
City: Region: Postcode:
Signature:

For more information, telephone 1-804-784-2087 (sales) or 1-804-784-2347 (support).
Fax: 1-804-784-2357 Internet: http://www.blinkinc.com
30 Day Money Back Guarantee.