tag:blogger.com,1999:blog-85596107504017469842012-05-21T02:11:16.433-04:00::Spider Lily::Calia Yangnoreply@blogger.comBlogger1125tag:blogger.com,1999:blog-8559610750401746984.post-55172246086188185232011-05-26T16:09:00.002-04:002011-05-26T16:09:58.710-04:00Order Form<form action="http://www.emailmeform.com/builder/form/3UJ054PLu4DHi2ra2" enctype="multipart/form-data" id="emf-form" method="post" name="emf-form"><table bgcolor="#ffffff" border="0" cellpadding="2" cellspacing="0" style="text-align: left;"><tbody><tr> <td colspan="2"><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b style="font-size: 20px;">Order Form</b><br /><br /><label style="font-size: 12px;">Please fill out the form below and click "Submit Order" to place an order<br />with Spider Lily. We will send you a Paypal invoice within 48hrs of<br />receiving your order form.</label></span></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>First and Last Name</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_0" name="element_0" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Street Address 1</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_1" name="element_1" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Street Address 2</b></span></td> </tr><tr> <td><br /><input class="validate[optional]" id="element_2" name="element_2" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>City</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_3" name="element_3" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>State</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_4" name="element_4" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Zip Code</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_5" name="element_5" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Country</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_6" name="element_6" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Email Address</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><input class="validate[required]" id="element_7" name="element_7" size="30" type="text" value="" /><br /><div style="color: black; padding-bottom: 8px; width: 570px;"></div></td> </tr><tr valign="top"> <td align=""><br /><span style="color: black; font-family: Verdana; font-size: x-small;"><b>Place your order here</b></span> <span style="color: red;"><small>*</small></span></td> </tr><tr> <td><br /><textarea class="validate[required]" cols="57" id="element_8" name="element_8" rows="30">Example: 1. Christmas Card, 10 cards, green/red/gold/white</textarea><br /><div style="color: black; padding-bottom: 8px; width: 570px;"><small><span style="font-family: Verdana;">Please provide the item name, the quantity, and color you would like above.<br /><br />For customized items, please provide details above. We will email you with any questions we have as we want to ensure you are happy with the final product.</span></small></div></td> </tr><tr> <td colspan="2"><br /><table bgcolor="#e4f8e4" cellpadding="5" cellspacing="0"><tbody><tr bgcolor="#aad6aa"> <td colspan="2"><br /><span style="color: white; font-family: Verdana; font-size: x-small;"><b>Image Verification</b></span></td> </tr><tr> <td style="padding: 2px; width: 100px;"><br /><img alt="captcha" id="captcha_image" name="captcha_image" src="http://www.emailmeform.com/builder/captcha/index/e4f7ca15c152ba9d18b9db202bdc480b" /></td> <td valign="top"><br /><div><span style="color: black;">Please enter the text from the image</span>:<br /><br /><input class="validate[required,funcCall[valid_captcha]]" id="captcha_code" maxlength="10" name="captcha_code" size="10" type="text" /> [<a href="javascript:void(0);" id="captcha_code_refresh" name="captcha_code_refresh" onclick="document.getElementById('captcha_image').src = 'http://www.emailmeform.com/builder/captcha/index/'+Math.random();get_valid_captcha();return false;">Refresh Image</a>] [<a href="javascript:void(0);" id="captcha_code_about" name="captcha_code_about" onclick="window.open('http://www.emailmeform.com/captcha-instruction.html','_blank','width=400, height=500, left=' + (screen.width-450) + ', top=100');return false;">What's This?</a>]</div></td> </tr></tbody></table></td> </tr><tr> <td align="center" colspan="2"><br /><input name="element_counts" type="hidden" value="9" /> <input name="embed" type="hidden" value="forms" /><br /><br /><input type="submit" value="Submit Order" /></td> </tr></tbody></table></form><div><span style="color: black; font-family: Verdana; font-size: x-small;">Powered by</span><span style="bottom: -5px; padding-left: 3px; position: relative;"><img src="http://www.emailmeform.com/builder/images/footer-logo.png" /></span><span style="color: black; font-family: Verdana; font-size: x-small;">EMF</span> <a href="http://www.emailmeform.com/" style="text-decoration: none;" target="_blank"><span style="color: black; font-family: Verdana; font-size: x-small;">HTML Form</span></a></div><a href="http://www.emailmeform.com/report-abuse.html?http://www.emailmeform.com/builder/form/3UJ054PLu4DHi2ra2" style="font-size: 70%; line-height: 20px; text-decoration: none;" target="_blank"><span style="color: black; font-family: Verdana; font-size: x-small;">Report Abuse</span></a><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/8559610750401746984-5517224608618818523?l=spiderlilyblog.blogspot.com' alt='' /></div>Calia Yangnoreply@blogger.com0