KGRKJGETMRETU895U-589TY5MIGM5JGB5SDFESFREWTGR54TY
Server : Apache/2.4.62
System : FreeBSD fbsdweb2.web.rcn.net 14.1-RELEASE FreeBSD 14.1-RELEASE releng/14.1-n267679-10e31f0946d8 GENERIC amd64
User : www ( 80)
PHP Version : 8.3.8
Disable Function : NONE
Directory :  /domains/magicjim/

Upload File :
current_dir [ Writeable ] document_root [ Writeable ]

 

Current File : /domains/magicjim/ORDERFORM.html
<HTML>  
<HEAD>
  <META NAME="GENERATOR" CONTENT="Adobe PageMill 3.0 Mac">
  <TITLE>SIMPLEX ORDER FORM</TITLE>
</HEAD>
<BODY>

<P ALIGN=CENTER><B><FONT SIZE="-1"><A HREF="ORDERFORM.html">ORDER
FORM</A></FONT></B></P>

<P ALIGN=CENTER><B><FONT SIZE="+1">JAMES RAINHO PRODUCTS - SIMPLEX
MAGIC<BR>
14 Windsor Rd. - Medford, MA 02155 - USA<BR>
Phone:(781)391-4104<BR>
</FONT>Email: [email protected]<BR>
<FONT COLOR="#000000" SIZE="-2">ORDER FORM<BR>
FOR STANDARD MAIL ORDERS ONLY - TO BE PAID BY CHECK OR MONEY ORDER<BR>
(IN US DOLLAR for International Orders)<BR>
</FONT></B><TABLE WIDTH="517" BORDER="1" CELLSPACING="2" CELLPADDING="0">
  <TR>
    <TD WIDTH="51%"><FONT SIZE="-1">FROM: (CustomerInformation<BR>
      Date:_________________________________<BR>
      NAME:_____________________________________________<BR>
      ADDRESS:_________________________________________<BR>
      CITY:______________________________________________<BR>
      STATE/PROVINCE:__________________________________<BR>
      POSTAL CODE:_____________________________________<BR>
      COUNTRY:_________________________________________<BR>
      TELEPHONE NUMBER:______________________________<BR>
      EMAIL:______________________________________</FONT><FONT SIZE="-2">_______</FONT></TD> 
    <TD WIDTH="49%">
      <P><FONT SIZE="-1">TO BE SHIPPED TO:<BR>
      (If same as on left - write &quot;same&quot; on first line)</FONT></P>

      <P><FONT SIZE="-1">NAME:___________________________________________<BR>
      ADDRESS:_______________________________________<BR>
      CITY:____________________________________________<BR>
      STATE/PROVINCE:________________________________<BR>
      POSTAL CODE:___________________________________<BR>
      COUNTRY_________________________________</FONT><FONT SIZE="-2">_______</FONT>
    </TD>
  </TR>
</TABLE><TABLE WIDTH="512" BORDER="1" CELLSPACING="2" CELLPADDING="0">
  <TR>
    <TD WIDTH="100%">
      <P ALIGN=CENTER><FONT SIZE="-1">ITEMS ORDER</FONT></P>

      <P ALIGN=CENTER><FONT SIZE="-1">...NO.---/--QTY.-/-----------------------------ITEM
      NAME----------------------/- UNIT PR.--/--TOTAL<BR>
      01/______/______/_____________________________________________________/_________/__________<BR>
      02/______/______/_____________________________________________________/_________/__________<BR>
      03/______/______/_____________________________________________________/_________/__________<BR>
      04/______/______/_____________________________________________________/_________/__________<BR>
      05/______/______/_____________________________________________________/_________/__________<BR>
      06/______/______/_____________________________________________________/_________/__________<BR>
      07/______/______/_____________________________________________________/_________/__________<BR>
      08/______/______/_____________________________________________________/_________/__________<BR>
      09/______/______/_____________________________________________________/_________/__________<BR>
      10/______/______/_____________________________________________________/_________/__________<BR>
      11/______/______/_____________________________________________________/_________/__________<BR>
      12/______/______/_____________________________________________________/_________/__________<BR>
      13/______/______/_____________________________________________________/_________/__________<BR>
      14/______/______/_____________________________________________________/_________/__________<BR>
      15/______/______/_____________________________________________________/_________/__________<BR>
      16/______/______/_____________________________________________________/_________/__________<BR>
      17/______/______/_____________________________________________________/_________/__________<BR>
      18/______/______/_____________________________________________________/_________/__________<BR>
      19/______/______/_____________________________________________________/_________/__________<BR>
      20/______/______/_____________________________________________________/_________/__________<BR>
      21/______/______/_____________________________________________________/_________/__________<BR>
      22/______/______/_____________________________________________________/_________/__________<BR>
      23/______/______/_____________________________________________________/_________/__________<BR>
      24/______/______/_____________________________________________________/_________/__________<BR>
      25/______/______/_____________________________________________________/_________/__________</FONT></P>

      <P ALIGN=RIGHT><FONT SIZE="-1">PRODUCTS TOTAL DOLLAR AMOUNT:__________________<BR>
      SHIPPING METHOD(Ground or Air):___________SHIPPING/HANDLING FEE:___________________<BR>
      INSURANCE FEE:__________________<BR>
      MASSACHUESETTS CUSTOMERS - ADD 6.25% SALES TAX:__________________<BR>
      TOTAL:______</FONT>_____________</P>

      <P ALIGN=CENTER>-&nbsp;
    </TD>
  </TR>
</TABLE><BR>
</P>

<P ALIGN=CENTER><A HREF="ORDERING%20INST.html"><B><FONT SIZE="+1">FOR
SHIPPING/HANDLING FEES &amp; INSURANCE FEES<BR>
CLICK HERE TO GO TO SHIPPING INSTRUCTIONS PAGE. <BR>
This applies ONLY to orders to be processed by mail.</FONT></B></A><BR>
<B><FONT SIZE="+1">PRINT OUT ORDER FORM ABOVE<BR>
Fill it in and mail it with check or money order to address above.</FONT></B></P>

<P ALIGN=CENTER><B><FONT SIZE="+1"><HR WIDTH="49%"></FONT></B></P>

<P ALIGN=CENTER><B><FONT SIZE="+1">USE RETURN (BACK UP) ARROW
TO RETURN TO LAST PAGE<BR>
OR CLICK BELOW TO:</FONT></B></P>

<P ALIGN=CENTER><B><FONT SIZE="+1"><BR>
</FONT><FONT SIZE="+2"><A HREF="INDEX.html">CLICK HERE TO RETURN
TO HOME PAGE</A></FONT></B>

</BODY>
</HTML>

Anon7 - 2021