tag:blogger.com,1999:blog-41933683084844172762011-04-22T07:01:58.738+08:00Welcome to my Special-Deals Corner !noreply@blogger.comBlogger11100tag:blogger.com,1999:blog-4193368308484417276.post-43771836422477293432007-12-31T21:57:00.000+08:002008-01-14T16:00:51.136+08:00<form action="http://www.freedback.com/mail.php" method="post" enctype="multipart/form-data" charset="UTF-8"><input id="acctid" type="hidden" value="r15t6yfpps1os4zg" name="acctid"> <input id="formid" type="hidden" value="335120" name="formid"><input id="required_vars" type="hidden" value="name,email,field-81c40aaad594623,field-23a993ad9ea238d" name="required_vars"><br /><table cellspacing="5" cellpadding="5" border="0"><tbody><tr><td valign="top">Name:<br /><input id="name" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="BACKGROUND-COLOR: #ffffa0" size="40" name="name"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Email Address:<br /><input id="email" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="BACKGROUND-COLOR: #ffffa0" size="40" name="email"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Confirm Email Address:<br /><input id="field-81c40aaad594623" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="BACKGROUND-COLOR: #ffffa0" size="40" name="field-81c40aaad594623"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Contact No:<br /><input id="field-23a993ad9ea238d" size="40" name="field-23a993ad9ea238d"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Delivery Address:<br /><textarea id="field-af5fe6eec9443ef" name="field-af5fe6eec9443ef" rows="6" cols="40"></textarea></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Postal Code:<br /><input id="field-9aa931873151cf9" title="Your Google Toolbar can fill this in for you. Select AutoFill" style="BACKGROUND-COLOR: #ffffa0" size="40" name="field-9aa931873151cf9"></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Order List (Product code/ Size/ Qty/Price/Item URL )<br /><textarea id="field-654e5b7ed12f8dd" name="field-654e5b7ed12f8dd" rows="6" cols="40"></textarea></td><td valign="top"><br /><br /></td></tr><tr><td valign="top"><br />Delivery Methods:<br /><select id="field-0a004f0835fbfe5" name="field-0a004f0835fbfe5"> <option value="Standard Mail (Additional $1.50 is applicable)">Standard Mail (Additional $1.50 is applicable)</option> <option value="Registered Mail (Additional $3.00 is applicable)">Registered Mail (Additional $3.00 is applicable)</option> <option value="Meet Up (Only at Choa Chu Kang Area)">Meet Up (Only at Choa Chu Kang Area)</option> <option value="Cash on Delivery (Only for purchase of $150 &amp; above)">Cash on Delivery (Only for purchase of $150 &amp; above)</option></select></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Payment Mode:<br /><select id="field-50aa3775c9c02dd" name="field-50aa3775c9c02dd"> <option value="Paypal (Additional 3.5% handling fees is applicable)">Paypal (Additional 3.5% handling fees is applicable)</option> <option value="ibanking">ibanking</option> <option value="ATM funds transfer">ATM funds transfer</option> <option value="Cheque (At your own risk)">Cheque (At your own risk)</option> <option value="Concealed Cash (At your own risk)">Concealed Cash (At your own risk)</option> <option value="Meet Ups (Only at Choa Chu Kang Area)">Meet Ups (Only at Choa Chu Kang Area)</option> <option value="Cash on Delivery (Only for purchase for $150 and above)">Cash on Delivery (Only for purchase for $150 and above)</option></select></td><td valign="top"><br /><br /><br /></td></tr><tr><td valign="top"><br />Other Comments:<br /><textarea id="field-5884e62c584cea2" name="field-5884e62c584cea2" rows="6" cols="40"></textarea></td><td valign="top"><br /><br /><br /></td></tr><tr><td align="middle" colspan="2"><br /><input type="submit" value=" Submit Form "><br /></td></tr></tbody></table><br /></form><br /><br /><center><span style="font-family:Arial, Helvetica;font-size:78%;"><b><br /></b></span> </center><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4193368308484417276-4377183642247729343?l=exudescpl-orderform.blogspot.com' alt='' /></div>Welcome to my Special-Deals Corner !noreply@blogger.com