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<title>Power Marketers Yearbook 1999: OnLine Order Form</title>
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<td width="36%"><img src="http://www.powermarketers.com/images/eeiyb99.gif" width="200" height="205" alt="1999 Power Marketers Yearbook" border="0"></td>
<td width="64%" rowspan="2" valign="middle"><strong><font size="4">Power Marketers
Yearbook 1999</font><br>
</strong><font size="3">Analysis, Profiles and Transactions</font><br>
<font size="2"><em>(Edison Electric Institute)</em></font><p><font size="5" color="#000080"><strong>OnLine Order Form</strong></font></p>
<p><em><strong><font size="2"> </font></strong></em></p>
<p><em><strong><font size="2">If you prefer to order by phone:</font></strong></em></p>
<p><strong><font size="3">Call (703) 641-0613</font></strong><font size="2"><br>
M-F, 9:00 a.m. - 5:00 p.m. (Eastern)</font></td>
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<td width="36%"></td>
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<table border="0" cellpadding="0" cellspacing="0" width="600">
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<td></td>
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<td><form METHOD="POST" name="Power Marketers Yearbook Order" action="../_vti_bin/shtml.dll/PMA/orderpmy.htm" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" S-Email-Format="TEXT/PRE" S-Email-Address="[email protected]" B-Email-Label-Fields="TRUE" B-Email-ReplyTo-From-Field="TRUE" S-Email-ReplyTo="Web Server" B-Email-Subject-From-Field="FALSE" S-Email-Subject="Power Marketers Yearbook Order" S-Builtin-Fields="Date Time" U-Confirmation-Url="pmy-cfrm.htm" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" --><p> </p>
<p>Please provide the following ordering information:</p>
<blockquote>
<table>
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<td ALIGN="right"><em>First name</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_FirstName" SIZE="25"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Last name</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_LastName" SIZE="25"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Middle initial</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_MiddleInitial" SIZE="4" MAXLENGTH="1"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Title</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_Title" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Organization</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_Organization" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Street address</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_StreetAddress" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Address (cont.)</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_Address2" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>City</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_City" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>State/Province</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_State" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Zip/Postal code</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_ZipCode" SIZE="12" MAXLENGTH="12"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Country</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_Country" SIZE="25"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Work Phone</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_WorkPhone" SIZE="25" MAXLENGTH="25"> </td>
</tr>
<tr>
<td ALIGN="right"><em>FAX</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_FAX" SIZE="25" MAXLENGTH="25"> </td>
</tr>
<tr>
<td ALIGN="right"><em>E-mail</em></td>
<td><input TYPE="TEXT" NAME="Purchaser_Email" SIZE="25"> </td>
</tr>
</table>
</blockquote>
<p>Please be sure to enter the number of copies you are ordering in the "QTY"
box below.</p>
<blockquote>
<table>
<tr>
<td><strong>QTY</strong></td>
<td><strong>DESCRIPTION</strong></td>
</tr>
<tr>
<td><input TYPE="TEXT" NAME="Ordering_OrderQty0" SIZE="6" MAXLENGTH="6"></td>
<td><input NAME="Ordering_OrderDesc0" SIZE="45" value="The Power Marketers Yearbook 1999">
</td>
</tr>
<tr>
<td></td>
<td>@ $498.00 per copy (includes shipping/handling.)</td>
</tr>
<tr>
<td></td>
<td></td>
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<td></td>
<td></td>
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<td></td>
<td></td>
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<td><strong><img src="http://www.powermarketers.com/images/credit.gif" width="153" height="34" alt="credit.gif (1794 bytes)" border="0" vspace="8"></strong></td>
<td></td>
</tr>
<tr>
<td><strong>BILLING</strong></td>
<td></td>
</tr>
<tr>
<td><div align="right"><p><em>Credit card</em></td>
<td><select NAME="Ordering_CardType" size="1">
<option selected>VISA </option>
<option>MasterCard </option>
<option>American Express </option>
</select> </td>
</tr>
<tr>
<td ALIGN="right"><em>Cardholder name</em></td>
<td><input TYPE="TEXT" NAME="Ordering_CardHolderName" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Card number</em></td>
<td><input TYPE="TEXT" NAME="Ordering_CardNumber" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Expiration date</em></td>
<td><input TYPE="TEXT" NAME="Ordering_CardExpiration" SIZE="5" MAXLENGTH="5"> </td>
</tr>
<tr>
<td ALIGN="right"></td>
<td><hr>
</td>
</tr>
<tr>
<td ALIGN="right"></td>
<td><input type="checkbox" name="Invoice" value="Bill_Me"> Bill Me</td>
</tr>
</table>
<table>
<tr>
<td></td>
<td> <p><strong>SHIPPING ADDRESS </strong>(<em>if different than information provided
above)</em></td>
</tr>
<tr>
<td ALIGN="right"><em>Street address</em></td>
<td><input TYPE="TEXT" NAME="Ordering_StreetAddress" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Address (cont.)</em></td>
<td><input TYPE="TEXT" NAME="Ordering_Address2" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>City</em></td>
<td><input TYPE="TEXT" NAME="Ordering_City" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>State/Province</em></td>
<td><input TYPE="TEXT" NAME="Ordering_State" SIZE="35"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Zip/Postal code</em></td>
<td><input TYPE="TEXT" NAME="Ordering_ZipCode" SIZE="12" MAXLENGTH="12"> </td>
</tr>
<tr>
<td ALIGN="right"><em>Country</em></td>
<td><input TYPE="TEXT" NAME="Ordering_Country" SIZE="25"> </td>
</tr>
</table>
</blockquote>
<blockquote>
<p>Please allow a few moments (<em>up to 60 seconds</em>) after clicking the "Submit
Order" button below for processing of your order information. You will receive
an immediate, on-screen confirmation message upon successful receipt of your order. </p>
<p>Thank you for your patience!</p>
</blockquote>
<p><input TYPE="submit" VALUE="Submit Order"> <input TYPE="RESET" VALUE="Reset Form"></p>
</form>
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</table>
<p><a href="http://www.powermarketers.com/pmyrbook.htm">Back</a></p>
<strong><em><font size="2">Thank you for your order!</font></em></strong>
Copyright 1999 by The Power Marketing Association OnLine
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