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<html>
<head>
<meta http-equiv="Content-Type"
content="text/html; charset=iso-8859-1">
<meta name="GENERATOR" content="Microsoft FrontPage Express 2.0">
<title>Order Form</title>
</head>
<body bgcolor="#FFFFFF" text="#000080" link="#000080"
vlink="#000080" alink="#000080">
<font color="#000080" size="4">You can place your order either by calling us at&nbsp;&nbsp;<big> (905) 609 0989 </big>&nbsp;&nbsp;or by completing the form below and then clicking the
"Submit Form" button. After receiving the Order Form we will call you to confirm all details as well as form of payment.</font>
<form action="_vti_bin/shtml.dll/orderform.htm" method="POST" webbot-action="--WEBBOT-SELF--">
<!--webbot bot="SaveResults" u-file="_Pedidos" s-format="HTML/BR" s-label-fields="TRUE"
s-builtin-fields="Date Time REMOTE_NAME REMOTE_USER" s-form-fields
u-confirmation-url="thanks.htm" startspan --><input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"><!--webbot bot="SaveResults" endspan i-checksum="43374" -->
<p><font color="#000080" size="6"><em>Order Form</em></font></p>
<table border="0">
<tr>
<td><font size="3"><strong>Basket Type</strong> </font></td>
<td><font size="3"><select name="D1" size="1">
<option selected>ChocoDelight $ 39 each + tax</option>
<option>European $ 49 each + tax</option>
<option>Canadian $ 75 each + tax</option>
<option>Corporate $ 99 each + tax</option>
</select></font></td>
</tr>
<tr>
<td><font size="3"><strong>Quantity</strong></font></td>
<td><font size="3"><select name="Quantity" size="1">
<option selected>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
</select></font></td>
</tr>
<tr>
<td><font size="3"><strong>To be delivered on</strong>
</font></td>
<td><font size="3"><select name="Month" size="1">
<option selected>-</option>
<option>Jan</option>
<option>Feb</option>
<option>Mar</option>
<option>Apr</option>
<option>May</option>
<option>Jun</option>
<option>Jul</option>
<option>Aug</option>
<option>Sep</option>
<option>Oct</option>
<option>Nov</option>
<option>Dec</option>
</select><select name="Day" size="1">
<option selected>-</option>
<option>1</option>
<option>2</option>
<option>3</option>
<option>4</option>
<option>5</option>
<option>6</option>
<option>7</option>
<option>8</option>
<option>9</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
<option>21</option>
<option>22</option>
<option>23</option>
<option>24</option>
<option>25</option>
<option>26</option>
<option>27</option>
<option>28</option>
<option>29</option>
<option>30</option>
<option>31</option>
</select><select name="Year" size="1">
<option>1999</option>
</select></font></td>
</tr>
</table>
<table border="0">
<tr>
<td><font size="2"><strong>All prices include
delivery in the Mississauga / Oakville area delimited
by Highways 427, 401 and Dorval Street.&nbsp;
<br> Please add $10 for Toronto deliveries.</strong></font></td>
</tr>
<tr>
<td><font size="2"><strong>For deliveries outside the
above areas please call us at&nbsp; (905)&nbsp; 609
0989 for S&amp;H charges.</strong></font></td>
</tr>
<tr>
<td><font color="#000080" size="2"><em><strong>Yes, I
would like to order the above basket(s) from</strong></em></font><font
color="#000080" size="1" face="Baskerville"><strong> </strong></font><font
color="#000080" size="6" face="Baskerville"><em>WonderGifts</em></font><font
color="#000080" face="Baskerville">.</font></td>
</tr>
</table>
<div align="left"><table border="1">
<tr>
<td>&nbsp;</td>
<td colspan="3"><font color="#000080" size="3"><strong>Basket(s)
Ordered by:</strong></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Telephone </font></td>
<td colspan="3"><font color="#000080" size="2">Area
Code </font><select name="Ordering_AreaCodeTel"
size="1">
<option selected>905</option>
<option>416</option>
</select><font color="#000080" size="2"> Phone #<input
type="text" size="8" name="Ordering_Telephone">ext.<input
type="text" size="5" name="Ordering_Tel_ext."></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Last Name</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="26" name="Ordering_First_Name"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">First Name</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="26" name="Ordering_Last_Name"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">E-mail Address</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="34" name="Ordering _E-mail"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Street Address</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="34" name="Ordering_Street_Address">
</font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Nearest
Intersection</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="34"
name="Ordering_Nearest_Intersection"> </font></td>
</tr>
<tr>
<td><font color="#000080" size="2">City</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="29" name="Ordering_City"> </font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Province</font></td>
<td><font color="#000080" size="2"><input type="text"
size="11" name="Ordering_Province" value="Ontario">
Postal Code <input type="text" size="10"
maxlength="12" name="Ordering_Postal_Code"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Additional Info
(eg. fax)</font></td>
<td colspan="3"><font color="#000080" size="2"><input
type="text" size="35" name="Ordering_Add_Info"> </font></td>
</tr>
</table>
</div><p>&nbsp;</p>
<div align="left"><table border="1">
<tr>
<td>&nbsp;</td>
<td><font color="#000080" size="3"><strong>Basket(s)
to be Shipped to:</strong></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Telephone </font></td>
<td><font color="#000080" size="2">Area Code </font><select
name="Ship_AreaCodeTel" size="1">
<option selected>905</option>
<option>416</option>
</select><font color="#000080" size="2"> Phone #<input
type="text" size="8" name="Ship_Telephone">ext.<input
type="text" size="5" name="Ship_TelExt"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Last Name</font></td>
<td><font color="#000080" size="2"><input type="text"
size="26" name="Ship_Last_Name"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">First Name</font></td>
<td><font color="#000080" size="2"><input type="text"
size="26" name="Ship_First_Name"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">E-mail Address</font></td>
<td><font color="#000080" size="2"><input type="text"
size="35" name="Ship_E-Mail"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Street Address</font></td>
<td><font color="#000080" size="2"><input type="text"
size="35" name="Ship_Street_Address"> </font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Nearest
Intersection</font></td>
<td><font color="#000080" size="2"><input type="text"
size="35" name="Ship_Nearest_Intersection"> </font></td>
</tr>
<tr>
<td><font color="#000080" size="2">City</font></td>
<td><font color="#000080" size="2"><input type="text"
size="29" name="Ship_City"> </font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Province</font></td>
<td><font color="#000080" size="2"><input type="text"
size="11" name="Ship_Province" value="Ontario">
Postal Code <input type="text" size="10"
maxlength="12" name="Ship_PostalCode"></font></td>
</tr>
<tr>
<td><font color="#000080" size="2">Additional Info
(eg. fax)</font></td>
<td><font color="#000080" size="2"><input type="text"
size="35" name="Ship_Add_Info"> </font></td>
</tr>
</table>
</div><p><font color="#000080"><em><input type="submit"
name="OrderForm" value="Submit Form"> <input type="reset"
value="Reset Form"> </em></font></p>
<p><font color="#000080"><em></em></font>&nbsp;</p>
</form>
</body>
</html>