NewsBin Order Form

Name:___________________________________

Street Address:______________________________________________

City:__________________________ State:____  ZIP:_____________

Country:_______________________

Phone: ________________________

NOTE: Your address is required for credit card verification.  
Phone number will only be used if your email address bounces.

Email Address:  (IMPORTANT!)_______________________________

Credit Card Type:  ________________ (VISA or Master Card only)

Credit Card Number: ________________________ Expiration: _____

Please email this form to sales@newsbin.com or mail to:

DJI Interprises, LLC
ATTN: NewsBin
P.O. Box 7482
Fairfax Station, VA 22039

If paying by check or money order please make it payable to
DJI Interprises, LLC in the amount of $19.95 ($20.85 for
Virginia residents) and send to the above address.