printable order form

<% ' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit. On Error Resume Next Session("FP_OldCodePage") = Session.CodePage Session("FP_OldLCID") = Session.LCID Session.CodePage = 1252 Session.LCID = 1033 Err.Clear strErrorUrl = "" If Request.ServerVariables("REQUEST_METHOD") = "POST" Then If Request.Form("VTI-GROUP") = "0" Then Err.Clear Set fp_conn = Server.CreateObject("ADODB.Connection") FP_DumpError strErrorUrl, "Cannot create connection" Set fp_rs = Server.CreateObject("ADODB.Recordset") FP_DumpError strErrorUrl, "Cannot create record set" fp_conn.Open Application("_ConnectionString") FP_DumpError strErrorUrl, "Cannot open database" fp_rs.Open "", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable FP_DumpError strErrorUrl, "Cannot open record set" fp_rs.AddNew FP_DumpError strErrorUrl, "Cannot add new record set to the database" Dim arFormFields0(0) Dim arFormDBFields0(0) Dim arFormValues0(0) FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0 fp_rs.Update FP_DumpError strErrorUrl, "Cannot update the database" fp_rs.Close fp_conn.Close FP_FormConfirmation "text/html; charset=windows-1252",_ "Form Confirmation",_ "Thank you for submitting the following information:",_ "form.html",_ "Return to the form." End If End If Session.CodePage = Session("FP_OldCodePage") Session.LCID = Session("FP_OldLCID") %> printable order form

PRINTING INSTRUCTIONS: select - FILE then PRINT PREVIEW then select 100%

instead of "Shrink to fit" from the drop down menue

This is not a secure page. Write credit card numbers on form after printing

List parts, then print this form and fax it to 845-297-9772.

Customer name *

Company name

Shipping address *

City * State * Postal code *

Phone number * email

Payment method Visa MasterCard Check

PRINT FORM, WRITE CARD NUMBER BELOW AND FAX TO 845-297-9772

Card number _________________________________________________________

Expiration date ____________ Name on card *

Card Holder Address if different than ship address

City State Postal code

	QTY	DESCRIPTION	UNIT COST	AMOUNT











			Item total
		If blank we will calculate shipping	Shipping
			Subtotal
		New York State residents	NY State tax
		* DENOTES REQUIRED FIELDS	Total