Order Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=110 BGCOLOR="#003300" TEXT="#F7F7FF" bgproperties="fixed" background="03f006e0dvmwbg.png"> <div> <B>Mickle's Pickles</B><FONT SIZE="6" COLOR="#FFFFCC" FACE="Times New Roman" ><B> </B></FONT><FONT SIZE="1" COLOR="#FFFFCC" FACE="Arial" ><B>   -  </B></FONT><FONT SIZE="4" COLOR="#FFFBF0" FACE="Times New Roman" ><B>The Second Best Pickle on the Planet!</B></FONT></div> <bR> <div> <B>                     Order Form</B></div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#996633" TEXT="#080000" background="040bec00ddvuxr.png"> <div> <A HREF="index.htm" TARGET="_top" TITLE="Mickles Pickles"><U><B>Back to Main Menu</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Products"><U><B>Product Information</B></U></A><FONT SIZE="2" COLOR="#333399" FACE="Arial" ><B> </B></FONT></div> <div> <A HREF="id28.htm" TARGET="_top" TITLE="Ordering"><U><B>Back to Ordering Page</B></U></A><FONT SIZE="3" COLOR="#FFFFCC" FACE="Arial" ><A HREF="id28.htm" TARGET="_top" TITLE="Ordering"><U><B> </B></U></A></FONT></div> <bR> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <B>  </B><FONT SIZE="3" COLOR="#000000" FACE="Arial" >Order Number: ___________ Date Received: ______________ </FONT></div> <div>                             <FONT SIZE="2" COLOR="#000000" FACE="Arial" >(Office use only)                                        (Office use only) </FONT></div> <bR> <div> Order Form - <FONT SIZE="3" COLOR="#000000" FACE="Arial" >(To make copy - right click on here and print) </FONT></div> <bR> <div> <B>Instructions:</B> Complete form and mail with check to: </div> <bR> <div> Pickle Order, 420 Glenwood St., Picayune, MS 39466<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <bR> <div> Last Name: ____________________ First Name: _______________________ </div> <bR> <div> Ship to Address: _________________________________________________ </div> <bR> <div> ______________________________________________________________ </div> <bR> <div> ______________________________________________________________ </div> <bR> <div>       </div> <div> Phone Numbers: _________________________________________________ </div> <bR> <div> -------------------------------------------------------------------------------------------------------------- </div> <bR> <div>                 (Fill in how many jars of each you wish.) </div> <bR> <div>                                   ___ Original        ___ Not Hot Jalapeno </div> <bR> <div>                                  4 - 11 jars   $9.50 each</div> <div>                                 12 - 24 jars  $7.25 each</div> <bR> <div>                                <FONT SIZE="2" COLOR="#003300" FACE="Arial" >UPS Shipping & Handling included in price</FONT><FONT SIZE="2" COLOR="#008000" FACE="Arial" >.</FONT></div> <bR> <div>        <FONT SIZE="3" COLOR="#800080" FACE="Arial" >Please call 601-798-0705 if you want to order more than 24 jars.</FONT><FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> These prices are for the contiguous 48 states. <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><U>Contact me</U></FONT> for other places.<FONT SIZE="3" COLOR="#000000" FACE="Arial" > </FONT></div> <div> --------------------------------------------------------------------------------------------------------------- </div> <bR> <div> <FONT SIZE="4" COLOR="#003300" FACE="Arial" >4 - 11 jars </FONT>Number of jars ____ X $9.50 = _________ </div> <bR> <div> <FONT SIZE="4" COLOR="#003300" FACE="Arial" >12 or more jars </FONT>Number of jars ____ X $7.25 = _________ </div> <bR> <div>                     <FONT SIZE="2" COLOR="#003300" FACE="Arial" >UPS Shipping & Handling included in price.</FONT></div> <bR> <div> Date: _____________ Check # __________Total = _________ </div> <bR> <div>                     (You may want to make a copy of this for your records.) </div> <div> ----------------------------------------------------------------------------------------------------------------- </div> <bR> <div> Mail order form with check to: </div> <bR> <div> Pickle Order    420 Glenwood St.    Picayune, MS 39466<FONT SIZE="3" COLOR="#003300" FACE="Arial" > </FONT></div> <bR> <bR> <div> <FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="id28.htm" TARGET="_top" TITLE="Ordering"><U><U>Back </U></U></A></FONT>                                                <A HREF="index.htm" TARGET="_top" TITLE="Mickles Pickles"><U> </U></A><FONT SIZE="3" COLOR="#0000FF" FACE="Arial" ><A HREF="index.htm" TARGET="_top" TITLE="Mickles Pickles"><U><U>Home</U></U></A></FONT></div> <bR> </td> </tr></table></body>