Ship Thinky video to:


Name_________________________________

Address________________________Apt:____

City_______________State______Zip_______

Country_______________

Phone________________


Payment Method: Enclose personal check, money order, or credit card information as indicated below. Make checks payable to Third Wave Media, at 290 Taconic Rd., Greenwich Ct. 06831


Credit Account Number________________________________

Card Type__________________

Expiration Date (month/year)____________

Billing Address Zip code ______________(Necessary for Credit Cards):