Western United States Group Buy - USB Block Erupter
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Pre-Order form for ASICMiner USB Block Erupter - Western United States

I am based in southern California, so orders to the western US will get fastest shipping.  However, I will accept orders from any United States address.  

The cost is a flat 2.1 BTC per miner.  This covers the cost of the miner plus packaging and handling.  Send payment then complete this form AFTER payment has been sent.

Once we reach 50 units ordered, payment will be sent to ASICMiner.  When I receive the units, they will be shipped by the next day.

Address for payment:
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Full Name *
Street Address line 1 *
Street Address line 2
If applicable
City *
State *
Zip code *
Email address *
Enter an email address at which I can contact you
Bitcoin address payment is sent from. *
Enter the Bitcoin address that payment has been sent from.
Number of USB Block Erupters ordered *
Total bitcoin payment sent *
Enter the total bitcoin payment sent (number ordered x 2.1 BTC)
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