Blinkinc Order Form -Valid in North and South America, Asia and Australia
Please print and complete this order form, then fax to Blinkinc on 1-804-784-2357 or mail to:
Blinkinc, P.O. Box 29858, Richmond, Virginia, 23242

Name:
Company:
Address 1: (no P.O. Boxes please)
Address 2:
City: State: Zip:
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 _______ _______
VA Residents please add 4.5% Sales Tax:     Tax: _______
Shipping & Handling: U.S.$15, Canada/Mexico $30, International $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.

__ Check enclosed (Must be drawn on U.S dollar account and payable to Blinkinc)
__ MasterCard __ VISA __ American Express Expiration Date:_____/_____
Card# . . . . . . . . . . . . . . . .

Card holder name and billing address (please print):

Name:
Company:
Address:
City: State: Zip:
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.