<![CDATA[
<HTML>
<HEAD>
<TITLE>George & Company</TITLE>
<META NAME="Logname" content="Order Form">
<META NAME="description" content=" ">
<META NAME="keywords" content="Commercial Printers, printers, checks, business forms, stationery, custom design, envelopes, continuous stock computer paper, copy paper, business cards, labels, typesetting">
</HEAD>
<BODY BGCOLOR=WHITE text=black link=0099cc vlink=CC0066>
<TABLE WIDTH=90%><TR><TD>
<TABLE BORDER=0 CELPADDING=0 CELLSPACING=0><TR><TD><IMG SRC="oftops.gif" WIDTH=326 HEIGHT=47 ALT="Career Opportunities"><BR>
<img src="tbgo.gif" width=326 height=51></TD></TR></TABLE><P>
<FONT FACE="arial, geneva">
<FONT FACE="arial, geneva" SIZE=-1>
Please supply necessary information that pertains to product(s) being purchased.<P>
<!--<FORM method="POST" action="/cgi-bin/mailform?georgeorder">-->
<form method="post" action="thankyou2.php3">
Date<BR>
<input type="text" name="date" size=20><P>
Your Name<BR>
<input type="text" name="name" size=50><P>
Company Name<BR>
<input type="text" name="coname" size=50><P>
E-mail<BR>
<input type="text" name="email" size=50><P>
Type of Order<BR>
<input type="checkbox" name="1a" value="new">new<BR>
<input type="checkbox" name="2a" value="repeat">exact repeat<BR>
<input type="checkbox" name="3a" value="repeatwithchange">repeat with change<P>
P.O.<BR>
<input type="text" name="po" size=50><P>
Requested Ship Date<BR>
<input type="text" name="shipdate" size=50><P>
Billing Address<BR>
<input type="text" name="bill" size=50><BR>
Attention<BR>
<input type="text" name="battn" size=50><P>
Shipping Address<BR>
<input type="text" name="shipadd" size=50><BR>
Attention<BR>
<input type="text" name="sattn" size=50><P>
Phone<BR>
<input type="text" name="phone" size=50><P>
Product(s) Requesting, Form Number, Description<BR>
<TEXTAREA name="products" rows=5 cols=50></TEXTAREA><P>
Quantity<BR>
<input type="text" name="quantity" size=50><P>
Overall Size<BR>
<input type="text" name="size" size=50><P>
Ink Color(s), # of Colors<BR>
<input type="text" name="colors" size=50><P>
Start #<BR>
<input type="text" name="start" size=20><P>
Method of Freight<BR>
<input type="checkbox" name="1b" value="GeorgeCoDeliver">George & Co. Deliver<BR>
<input type="checkbox" name="2b" value="ups">UPS<BR>
<input type="checkbox" name="3b" value="rfedex">Fedex<P>
<input type="checkbox" name="proof" value="proof Required">Proof Required<P>
Additional Information or Comments<BR>
<TEXTAREA name="comments" rows=5 cols=50></TEXTAREA><P>
<INPUT Type="submit" value="Send"> <INPUT Type="reset" value="Redo">
</FORM>
</FONT><P><BR>
</TD></TR></TABLE>
<TABLE><TR><TD><IMG SRC="logobottom.gif"></TD>
<TD><FONT SIZE=-1 FACE="arial, geneva">© 1997 George & Company<BR>
248.548.0260<P>
</FONT></TD></TR></TABLE>
<P>
</BODY>
</HTML>
]]>