Order Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" rowspan="3" width=153 BGCOLOR="#FFFFCC" TEXT="#080000"> <div> <B>Order Form</B></div> <div> <A HREF="quick_guide.htm" TARGET="_top" TITLE="Site Map"><U>Site Map</U></A></div> <bR> <div> <A HREF="purple_plate_prices.htm" TARGET="_top" TITLE="Prices"><U>Prices</U></A></div> <div> <B>Order Form</B></div> <div> <A HREF="help_others.htm" TARGET="_top" TITLE="Distributors"><U>Distributors</U></A></div> <div> <A HREF="find_us_worldwide_.htm" TARGET="_top" TITLE="Area Location Guide"><U>Area Location Guide</U></A></div> <div> <B>Please refer to the notice at the bottom of this screen before ordering.</B></div> <div> TAKE ME TO:</div> <div> <A HREF="order_form_m.htm#top_of_order_1" TARGET="TRLX_Middle" TITLE="Order Form"><U><I>Customer Details</I></U></A></div> <div> <A HREF="order_form_m.htm#product" TARGET="TRLX_Middle" TITLE="Order Form"><U><I>Product Details</I></U></A></div> <div> <A HREF="mailto:jackrampe@eip-pgp.com" TARGET="_top" TITLE="mailto:jackrampe@eip-pgp.com"><U><I>E-mail for </I></U></A><A HREF="mailto:jackrampe@eip-pgp.com" TARGET="_top" TITLE="mailto:jackrampe@eip-pgp.com"><U><I>Ship</I></U></A><A HREF="mailto:jackrampe@eip-pgp.com" TARGET="_top" TITLE="mailto:jackrampe@eip-pgp.com"><U><I>ping and Insurance Guide</I></U></A></div> <div> <A HREF="order_form_m.htm#top_of_order_1" TARGET="TRLX_Middle" TITLE="Order Form"><U><I>Top of Page</I></U></A></div> </td> <td valign="top" colspan=2 height=90 BGCOLOR="#990066" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#FFFFFF" FACE="Arial" ><B>Purple Harmony Plates - Expect A Miracle!</B></FONT><B>    </B><B> |     </B><A HREF="index.htm" TARGET="_top" TITLE="Purple Harmony Plates Expect A Miracle!"><U><B>home</B></U></A></div> <div> back to<B>  </B><A HREF="contact_us.htm" TARGET="_top" TITLE="Contact Us"><U><B>Contact Us</B></U></A><B> </B></div> <div> </div> </td> </tr><tr> <td valign="top" height=320 colspan=2 BGCOLOR="#FFFFFF" TEXT="#080000"> <div>  <A NAME="top_of_order_1"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="2" COLOR="#000000" FACE="Arial" >To print the order form click on the order form then select print from the File Menu.</FONT></div> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="648" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER ROWSPAN=2 BGCOLOR=#990066 HEIGHT= 16 ><NOBR><div> Purple Harmony Plates (USA)</div> <div> 44 Ruggles  St, Westboro MA 01581</div> </NOBR></tD> <tD VALIGN=CENTER BGCOLOR=#FFFFCC WIDTH="85"><div> Phone/Fax</div> </tD> <tD VALIGN=CENTER BGCOLOR=#990066 WIDTH="136"><div> <B>Order Form</B></div> </tD> <tD VALIGN=CENTER BGCOLOR=#990066><NOBR><div> <B>Please Print Clearly</B></div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER><NOBR><div> (508) 898-1970</div> </NOBR></tD> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#FFFFCC WIDTH="313"><div> <B>Credit Card Purchase</B></div> </tD> </tR> <tR> <tD VALIGN=CENTER BGCOLOR=#FFFFCC HEIGHT= 16 WIDTH="220"><div> Please Ship My Order To</div> </tD> <tD VALIGN=CENTER WIDTH="85"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="85" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER BGCOLOR=#FFFFCC WIDTH="136"><div> Circle to Select:</div> </tD> <tD VALIGN=CENTER><NOBR><div> Visa             Master card</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> Name:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><div> Name:</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> Address:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><div> Amount (USD):</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> City:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><div> Credit Card No:</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="308" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><div> Expiration Date:</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> State:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#FFFFCC><NOBR><div> I hereby certify that I am <FONT SIZE="1" COLOR="#000000" FACE="Arial" >(Name as presented on Card)</FONT></div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> Post Code:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="313" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> Country:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#FFFFCC><NOBR><div> and that I authorize an amount of (in words):</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 16 WIDTH="308"><div> Telephone:</div> </tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="313" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 HEIGHT= 66 WIDTH="308"><div> <B>Please make checks payable to</B><FONT SIZE="2" COLOR="#000000" FACE="Arial" ><B> Purple Harmony Plates </B></FONT><B>or complete the credit card details on the right.</B></div> </tD> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#FFFFCC WIDTH="313"><div> to be deducted from the above circled credit card.  I undertake to reimburse Purple Harmony Plates the sum shown above in the event of the transaction being rejected.</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#990066 HEIGHT= 16 ><NOBR><div> Thank you for your order and Expect A Miracle!</div> </NOBR></tD> <tD VALIGN=CENTER COLSPAN=2 WIDTH="313"><div> Signed:</div> </tD> </tR> </TABLE></div> <DIV ALIGN="LEFT"></DIV> <div>  <A NAME="product"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="1" HSPACE="0" VSPACE="0" ></A><FONT SIZE="2" COLOR="#000000" FACE="Arial" >To print the order form click on the order form then select print from the File Menu.</FONT></div> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="649" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=CENTER ROWSPAN=2 COLSPAN=3 BGCOLOR=#990066 HEIGHT= 16 WIDTH="292"><div> <B>Product</B></div> </tD> <tD VALIGN=CENTER ROWSPAN=2 BGCOLOR=#FFFFCC WIDTH="77"><div> Size</div> </tD> <tD VALIGN=CENTER COLSPAN=2 BGCOLOR=#990066 WIDTH="121"><div> Price</div> </tD> <tD VALIGN=CENTER BGCOLOR=#990066><NOBR><div> Quantity</div> </NOBR></tD> <tD VALIGN=CENTER BGCOLOR=#990066><NOBR><div> Extended</div> </NOBR></tD> </tR> <tR> <tD VALIGN=CENTER BGCOLOR=#990066 WIDTH="63"><div> Single</div> </tD> <tD VALIGN=CENTER BGCOLOR=#990066><NOBR><div> Quantity</div> </NOBR></tD> <tD VALIGN=CENTER BGCOLOR=#990066><NOBR><div> Ordered</div> </NOBR></tD> <tD VALIGN=CENTER BGCOLOR=#990066 WIDTH="57"><div> Value</div> </tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Plate - Small</div> </tD> <tD VALIGN=CENTER><NOBR><div> 4 1/2 " x 2 3/4"</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 15.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Plate - Large</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 12" x 12"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 48.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Disk - Small</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 1" diameter</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 7.50</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Disk - Large</div> </tD> <tD VALIGN=CENTER><NOBR><div> 1 1/2" diameter</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 7.50</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Angel - Small</div> </tD> <tD VALIGN=CENTER><NOBR><div> 1 3/8" x 1 3/8"</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 7.50</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Purple Harmony Angel - Large</div> </tD> <tD VALIGN=CENTER><NOBR><div> 2 1/8" x 2 1/4"</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 9.90</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Fridge Freshener</div> </tD> <tD VALIGN=CENTER><NOBR><div> 5" x 2 1/2" sq</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 33.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Green Thumb Energy Tube</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 3" x 1"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 24.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Car Fuel Ionizer</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 3" x 1"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 30.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Truck Fuel Ionizer</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 6" x 1 3/4"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 99.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Gold Hunza Water Ionizer</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 6" x 1 3/4"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 99.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Aqua Hunza Water Ionizer</div> </tD> <tD VALIGN=CENTER WIDTH="77"><div> 12" x 1 3/4"</div> </tD> <tD VALIGN=CENTER WIDTH="63"><div> 199.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=3 HEIGHT= 16 WIDTH="292"><div> Swimming Pool Ionizer</div> </tD> <tD VALIGN=CENTER><NOBR><div> Weight: 40 lbs</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="63"><div> 299.00</div> </tD> <tD VALIGN=CENTER WIDTH="55"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="55" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="50"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="50" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER COLSPAN=4 BGCOLOR=#FFFFCC HEIGHT= 16 WIDTH="372"><div> <B>Postage and Packaging Charges</B></div> </tD> <tD VALIGN=CENTER COLSPAN=3 BGCOLOR=#FFFFCC WIDTH="174"><div> <B>Sub Total:</B></div> </tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 16 ><NOBR><div> $  0.00 - $    50.00</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="62"><div> $  3.50</div> </tD> <tD VALIGN=CENTER><NOBR><div> $  50.01 - $100.00</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="77"><div> $  5.00</div> </tD> <tD VALIGN=CENTER COLSPAN=3 BGCOLOR=#FFFFCC><NOBR><div> <B>MA Residents Sales Tax 5%</B></div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 16 ><NOBR><div> $100.01 - $200.00</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="62"><div> $  8.00</div> </tD> <tD VALIGN=CENTER><NOBR><div> $200.01 - $300.00</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="77"><div> $11.00</div> </tD> <tD VALIGN=CENTER COLSPAN=3 BGCOLOR=#FFFFCC WIDTH="174"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="174" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="16" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 15 ><NOBR><div> $300.01 - $500.00</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="62"><div> $14.00</div> </tD> <tD VALIGN=CENTER><NOBR><div> $500.01 - $999.99</div> </NOBR></tD> <tD VALIGN=CENTER WIDTH="77"><div> $16.00</div> </tD> <tD VALIGN=CENTER ROWSPAN=2 COLSPAN=3 BGCOLOR=#FFFFCC WIDTH="174"><div> <B>Postage and Packaging:</B></div> </tD> <tD VALIGN=CENTER ROWSPAN=2 WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="15" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER HEIGHT= 17 WIDTH="112"><div> Over $1000.00</div> </tD> <tD VALIGN=CENTER WIDTH="62"><div> $18.00</div> </tD> <tD VALIGN=CENTER WIDTH="112"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="17" ALIGN="bottom" WIDTH="112" HSPACE="0" VSPACE="0"></tD> <tD VALIGN=CENTER WIDTH="77"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="17" ALIGN="bottom" WIDTH="77" HSPACE="0" VSPACE="0"></tD> </tR> <tR> <tD VALIGN=CENTER ROWSPAN=2 COLSPAN=6 BGCOLOR=#990066 HEIGHT= 1 ><NOBR><div> <B>Overseas Orders </B></div> <div> <B>Please e-mail us for your Shipping and Insurance Guide</B></div> </NOBR></tD> <tD VALIGN=CENTER ROWSPAN=2 BGCOLOR=#FFFFCC><NOBR><div> <B>Total:</B></div> </NOBR></tD> <tD VALIGN=CENTER ROWSPAN=2 WIDTH="57"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="1" ALIGN="bottom" WIDTH="57" HSPACE="0" VSPACE="0"></tD> </tR> <tR> </tR> </TABLE></div> <bR> </td> </tr><tr> <td valign="top" colspan=2 height=70 BGCOLOR="#FFFFCC" TEXT="#080000"> <div> <B>~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~</B></div> <div> <FONT SIZE="2" COLOR="#333399" FACE="Arial" ><B>NOTICE: </B></FONT><B>Currently we do NOT offer a secure credit card service and recommend that you print this order form.  After completing the details, either post or fax the form to the appropriate address as listed on the </B><A HREF="find_us_worldwide_.htm" TARGET="_top" TITLE="Area Location Guide"><U><B>Area Location Guide</B></U></A><B> page.  You may also phone your order to us on the appropriate number for your area.</B></div> <bR> </td> </tr></table></body>