tag:blogger.com,1999:blog-73876313184946400622011-04-21T12:11:25.568-07:00oh-so-wonderfulnoreply@blogger.comBlogger11100tag:blogger.com,1999:blog-7387631318494640062.post-17028703453447411862007-12-13T17:23:00.000-08:002007-12-13T18:00:32.946-08:00Please scroll down.<br /><br /><form action="http://www.response-o-matic.com/mail.php" method="post" enctype="multipart/form-data" charset="UTF-8"><br /><div><br /><input id="acctid" type="hidden" value="7ud3rdvgtrlo621d" name="acctid"><br /><input id="formid" type="hidden" value="327457" name="formid"><br /><input id="required_vars" type="hidden" value="name,field-97a03a887935e1d,email,field-65afad29ac85b9c,field-b6bc3645528b8f4,field-a9d2bd68992fe1c" name="required_vars"><br /></div><br /><table cellspacing="5" cellpadding="5" border="0"><br /><tbody><tr><br /><td valign="top"><br /><strong>Name:</strong><br /></td><br /><td valign="top"><br /><input id="name" size="40" name="name"><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Contact No.</strong><br /></td><br /><td valign="top"><br /><input id="field-97a03a887935e1d" size="40" name="field-97a03a887935e1d"><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Email Address:</strong><br /></td><br /><td valign="top"><br /><input id="email" size="40" name="email"><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Address</strong><br /></td><br /><td valign="top"><br /><textarea id="field-715219fcc228c99" name="field-715219fcc228c99" rows="6" cols="40"></textarea><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Item codes</strong><br /></td><br /><td valign="top"><br /><textarea id="field-65afad29ac85b9c" name="field-65afad29ac85b9c" rows="6" cols="40"></textarea><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Preferred method of getting your fashion items</strong><br /></td><br /><td valign="top"><br /><input id="field-b6bc3645528b8f4_0" type="checkbox" value="COD" name="field-b6bc3645528b8f4[]"> COD<br /><br /><input id="field-b6bc3645528b8f4_1" type="checkbox" value="Post" name="field-b6bc3645528b8f4[]"> Post<br /><br /><br /></td><br /></tr><br /><tr><br /><td valign="top"><br /><strong>Payment method</strong><br /></td><br /><td valign="top"><br /><input id="field-a9d2bd68992fe1c_0" type="checkbox" value="COD" name="field-a9d2bd68992fe1c[]"> COD<br /><br /><input id="field-a9d2bd68992fe1c_1" type="checkbox" value="Bank in" name="field-a9d2bd68992fe1c[]"> Bank in<br /><br /><br /></td><br /></tr><br /><tr><br /><td align="middle" colspan="2"><br /><input type="submit" value=" Submit Form "><br /></td><br /></tr><br /></tbody></table><br /></form><br /><br /><center><span style="font-family:Arial, Helvetica;font-size:78%;"><b><br /><a href="http://www.response-o-matic.com/">create form</a><br /></b></span></center><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/7387631318494640062-1702870345344741186?l=oh-so-wonderful-of.blogspot.com' alt='' /></div>oh-so-wonderfulnoreply@blogger.com0