Online Order Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0><script type="text/javascript" src="http://hb.lycos.com/hb.js"></script> <script type="text/javascript" src="http://ratings.lycos.com/ratings/lycosRating.js.php"></script> <script type="text/javascript"><![CDATA[//><!]]></script> <script type="text/javascript" src="http://scripts.lycos.com/catman/init.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-start.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-middle.js"></script> <script type="text/javascript" src="http://members.tripod.com/adm/ad/code-end.js"></script> <noscript> <img src="http://members.tripod.com/adm/img/common/ot_noscript.gif?rand=943459" alt="" width="1" height="1" />  <iframe frameborder="0" marginwidth="0" marginheight="0" scrolling="no" width="728" height="90" src="http://ad.yieldmanager.com/st?ad_type=iframe&ad_size=728x90&section=209094"></iframe>  </noscript> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=100 BGCOLOR="#CCCCFF" TEXT="#080000" bgproperties="fixed" background="0f800640egdysm.jpg"> <div> <FONT SIZE="5" COLOR="#000066" FACE="Arial" ><B>Personally Yours Photo Gift Center</b></FONT><FONT SIZE="5" COLOR="#000099" FACE="Arial" ><B> </b></FONT><B>    |     </b><A HREF="index.htm" TARGET="_top" TITLE="Personally Yours Photo Gift Center"><U><B>home</b></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="Personally Yours Photo Gift Center Info"><U>Personally Yours Photo Gift Center Info</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="How To Order"><U>How To Order</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Our Products and Services"><U>Our Products and Services</U></A>   |   <B>Online Order Form</b></div> <div> </div> </td> </tr><tr> <td valign="top" width=200 BGCOLOR="#0000BF" TEXT="#F7F7FF"> <bR> <div> <I><B>Personally Yours Photo Gift Center</b></I></div> <bR> <div> <A HREF="mailto:rrasta@lycos.com" TARGET="_top" TITLE="mailto:rrasta@lycos.com"><U><I><B><IMG SRC="11543320.gif" border=0 width="67" height="50" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></b></I></U></A></div> <div> <A HREF="id22.htm" TARGET="_top" TITLE="Framed Canvas Paintings"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Framed Canvas Paintings</b></U></A></div> <div> <A HREF="id23.htm" TARGET="_top" TITLE="Photo Clocks"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Photo Clocks</b></U></A></div> <div> <A HREF="id24.htm" TARGET="_top" TITLE="Photo Mugs"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Photo Mugs</b></U></A></div> <div> <A HREF="id25.htm" TARGET="_top" TITLE="TShirts"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">T-Shirts</b></U></A></div> <div> <A HREF="id26.htm" TARGET="_top" TITLE="Key Tags Buttons"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Key Tags & Buttons</b></U></A></div> <div> <A HREF="id27.htm" TARGET="_top" TITLE="Photo Greeting Frames"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Photo Greeting Frames</b></U></A></div> <div> <A HREF="id28.htm" TARGET="_top" TITLE="Photo Pen Sets"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Photo Pen Sets</b></U></A></div> <div> <A HREF="id29.htm" TARGET="_top" TITLE="Photo Plates"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Photo Plates</b></U></A></div> <div> <A HREF="id31.htm" TARGET="_top" TITLE="Custom License Plate"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Custom License Plate</b></U></A></div> <div> <A HREF="id32.htm" TARGET="_top" TITLE="Personalized Mouse Pad"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Personalized Mouse Pad</b></U></A></div> <div> <A HREF="id35.htm" TARGET="_top" TITLE="Specialty Frames"><U><B><IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Specialty Frames</b></U></A></div> <bR> <DIV ALIGN="LEFT"></DIV> <div> <A HREF="http://www.members.tripod.com/orders.html" TARGET="_top" TITLE="http://www.members.tripod.com/orders.ht"><U><B><IMG SRC="11685640.gif" border=0 width="133" height="100" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></b></U></A></div> </td> <td valign="top" height=380 BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <I>Online Order Form</I></div> <div>  <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Address1,Address2,City,State,Zip,Phone,Order Information,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your order."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="Order Information"><input type="hidden" name="tlx_EmailTo" value="rrasta@aol.com"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Your Order Information:<br> <textarea name="Order Information" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="left">Comments:<br> <input type="text" name="Comments" size="30" maxlength="100"></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <div> <B>  <A HREF="https://www.paypal.com/verified/pal=rrasta%40aol.com" target="_blank"><IMG SRC="http://images.paypal.com/images/verification_seal.gif" BORDER="0" ALT="Official PayPal Seal"></A>   </b></div> <bR> <div> <A HREF="mailto:rrasta@lycos.com" TARGET="_top" TITLE="mailto:rrasta@lycos.com"><U><B>Email Photo</b></U></A></div> </td> </tr></table></body>