Communication Independence for
the Neurologically Impaired, Inc.

A NON-PROFIT ORGANIZATION

Print this Order Form

EYELINK ORDER FORM
Please send me: ______ Alphabet Layout  (Quantity)

______ Blank Layout  (Quantity)

Ship To
Name: 
Address:
City/State/Zip:
Telephone:
The EyeLink can be obtained by contacting CINI for a cost of $18.50 per EyeLink. Please add $7.00 for shipping and handling (per link). If ordering more than one EyeLink, please contact CINI for shipping costs.

If you are ordering outside of the U.S., please contact CINI for shipping costs.

Mail order form along with a check, to:

CINI
PO Box 263
Manorville, NY 11949
Telephone: (631) 878-0642
Fax: (631) 878-8333

E-mail: cini@cini.org