tag:blogger.com,1999:blog-18567086133410228512012-02-16T15:16:45.090-08:00wenwenzzzhttp://www.blogger.com/profile/10405086676085380176noreply@blogger.comBlogger11100tag:blogger.com,1999:blog-1856708613341022851.post-78967645643455612482007-12-08T20:48:00.000-08:002008-01-12T06:46:26.592-08:00<form action="http://www.freedback.com/mail.php" method="post" enctype="multipart/form-data" charset="UTF-8"><input id="acctid" type="hidden" value="pn9ea9c1woa92snc" name="acctid"> <input id="formid" type="hidden" value="339037" name="formid"><input id="required_vars" type="hidden" value="name,email,field-821d8cffc0259d7,field-d23028cd0b8069a,field-c47834350ce01a6,field-218ef9b62e660b4,field-2ad3c2e26ffdadd" name="required_vars"><br /><table cellspacing="5" cellpadding="5" border="0"><tbody><tr><td valign="top">Name:<br /><input id="name" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="WIDTH: 308px; HEIGHT: 18px; BACKGROUND-COLOR: #ffffa0" size="45" name="name"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top">Email Address:<br /><input id="email" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="WIDTH: 308px; HEIGHT: 18px; BACKGROUND-COLOR: #ffffa0" size="44" name="email"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top">Confirm Email Address:<br /><input id="field-821d8cffc0259d7" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="WIDTH: 308px; HEIGHT: 18px; BACKGROUND-COLOR: #ffffa0" size="45" name="field-821d8cffc0259d7"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top">Contact number:<br /><input id="field-155efa3c41376c9" style="WIDTH: 308px; HEIGHT: 18px" size="45" name="field-155efa3c41376c9"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top">Delivery Address:<br /><textarea id="field-d23028cd0b8069a" style="WIDTH: 373px; HEIGHT: 100px" name="field-d23028cd0b8069a" rows="6" cols="41"></textarea></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Your Order List (Product Code / Size / Colour / Qty / Price):<br /><textarea id="field-c47834350ce01a6" style="WIDTH: 373px; HEIGHT: 100px" name="field-c47834350ce01a6" rows="6" cols="41"></textarea></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Delivery Mode:<br /><select id="field-218ef9b62e660b4" style="WIDTH: 373px" name="field-218ef9b62e660b4"> <option value="Local Registered Mail (extra $2.24 is applicable)">Local Registered Mail (extra $2.24 is applicable)</option> <option value="Local Normal Mail">Local Normal Mail</option> <option value="Overseas">Overseas</option></select></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Payment Method:<br /><select id="field-2ad3c2e26ffdadd" style="WIDTH: 373px" name="field-2ad3c2e26ffdadd"> <option value="DBS / POSB Internet Banking">DBS / POSB Internet Banking</option><br /><option value="DBS / POSB ATM funds transfer">DBS / POSB ATM funds transfer</option><br /><option value="OCBC Internet Banking">OCBC Internet Banking</option><br /><option value="UOB Internet Banking">UOB Internet Banking</option><br /><option value="Credit Card (Paypal, 3.4% handling fees is applicable)">Credit Card (Paypal, 3.4% handling fees is applicable)</option> <option value="International Telegraphic Transfer (Overseas)">International Telegraphic Transfer (Overseas)</option></select></td><td valign="top"><br /><br /></td></tr><tr><td valign="top"><br />Remarks:<br /><textarea id="field-a8644e77fb93666" style="WIDTH: 373px; HEIGHT: 100px" name="field-a8644e77fb93666" rows="6" cols="40"></textarea></td><td valign="top"><br /><br /><br /></td></tr><tr><td align="middle" colspan="2"><br /><input type="submit" value=" Submit Form "><br /></td></tr></tbody></table><br /><span style="font-family:Arial, Helvetica;font-size:78%;"><b><br /></b></span></form><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/1856708613341022851-7896764564345561248?l=wenwenzzz-orderform.blogspot.com' alt='' /></div>wenwenzzzhttp://www.blogger.com/profile/10405086676085380176noreply@blogger.com0