<HTML>
<HEAD>
<TITLE>Order QUE Books ONLINE</TITLE>
</HEAD>
<BODY>
<H1>Order QUE Books Online</H1>
<p>
<hr>
<H2>Customer Information</H2>
<FORM ACTION="formmail.pl" METHOD="POST">
<INPUT TYPE="hidden" NAME="subject" VALUE="Book Order">
<INPUT TYPE="hidden" NAME="recipient" VALUE="sales@que.books.com">
<pre>
Name:<INPUT TYPE="text" NAME="realname">
Email:<INPUT TYPE="text" NAME="email">
<b>Postal Address:</b>
Street (line1):<INPUT TYPE="text" NAME="street1">
Street (line2):<INPUT TYPE="text" NAME="street2">
City:<INPUT TYPE="text" NAME="city">
State:<INPUT TYPE="text" NAME="state" SIZE=12>
Country:<INPUT TYPE="text" NAME="country" SIZE=12>
ZIP Code:<INPUT TYPE="text" NAME="zip" SIZE=6>
Phone Number:<INPUT TYPE="text" NAME="phone" SIZE=13>
</pre>
<p>
<hr>
<H2>Product Information</h2>
<p>
<pre>
<INPUT TYPE="checkbox" NAME="SP_Using_CGI" VALUE="order">Special Edition: Using CGI
Quantity:<INPUT TYPE="text" NAME="qnty_CGI" SIZE=4>
<INPUT TYPE="checkbox" NAME="SP_Using_HTML" VALUE="order">Special Edition: Using HTML
Quantity:<INPUT TYPE="text" NAME="qnty_HTML" SIZE=4>
If you would like additional information on other products, or on
bulk purchasing arrangements, please leave us a note:
<TEXTAREA NAME="Comments" ROWS=6 COLS=60> </TEXTAREA>
</pre>
<p>
<H2>Payment information</H2>
<p>
<pre>
Would you like to pay with:<br>
<INPUT TYPE="radio" NAME="CreditCard" VALUE="Visa"> Visa
<INPUT TYPE="radio" NAME="CreditCard" VALUE="MasterCard"> Master Card
<INPUT TYPE="radio" NAME="CreditCard" VALUE="A_Express"> American Express
<INPUT TYPE="radio" NAME="CreditCard" VALUE="Discover"> Discover
Name on credit card:<INPUT TYPE="text" NAME="Full_Name" SIZE=60>
Credit Card Number:<INPUT TYPE="text" NAME="cc_number" SIZE=19>
Expiration Date:<INPUT TYPE="text" NAME="expires" SIZE=7>
</pre>
<p>
<INPUT TYPE="submit" VALUE="Process Order">
or
<INPUT TYPE="reset" VALUE="Clear Form">
<p>
</FORM>
</BODY>
</HTML>