This form may be used for ordering. Please print this page (or cut and paste) and fill it in clearly. Send it to us by fax, mail, or email.


Your name____________________________________________________________________________


Organization/Company__________________________________________________________________


Email (type clearly)_____________________________________________________________________


Mail address___________________________________________________________________________


Zip____________________ Town____________________________ Country_______________________


Phone__________________________________ Fax___________________________________________


WWW homepage_______________________________________________________________________

ORDERED PROGRAMS (check box to the left)
(  ) HEAT2 & HEAT3 Package license $1200
(  ) HEAT2 license $700
(  ) HEAT3 license $900
- Prices above are for a single user license, manuals are free to download in PDF-format (Adobe Acrobat).
- Installation files for the above programs are sent by email within a few days. Make sure that your email is given above. 

(  ) Other (specify)_______________________________________________________ $________

(  ) Other (specify)_______________________________________________________ $________

                                                                                                                     Total $________
SELECT PAYMENT ALTERNATIVE:

1. (  ) Pay by credit card:    (  )MasterCard        (  )VISA        (  )AMEX        (  )DINERS

    Card number:_______________________________________________________________________

    Expiration date:  month:_______________       /    year:______________

    Name of cardholder:_________________________________________________________________

2. (  ) Send invoice
-Invoice sent by mail, 21 days net, you pay the fees of your bank. This option may only be checked by universities, companies with more than 20 employees, and already known customers.

3. (  ) Prepay by sending check or bank transfer. Please contact us for more information.


Please sign your name:_______________________________________________ Date:___________

Type your name clearly:_______________________________________________________________

USER INFORMATION
Where did you hear about our products?_______________________________________________

BLOCON SWEDEN, Iliongr. 159, S-224 72 Lund, Sweden, Fax: +46 46-136264
BLOCON USA, 27 Hillcrest Rd, Reading, MA 01867, USA, Fax: +1 702 974 5432
www.buildingphysics.com, www.blocon.sewww.blocon.com, Email: info@blocon.se (Ver 050122)