HTML Site Design - Secure Ordering Form Demo Page

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HTML Site Design^®

The below form will be modified to include Your products, prices and ordering check off boxes.

This form works exactly like our 'FileSaver' feature, but does not e-mail your customers financial information. All submitted information via our Secure Ordering Form is written to a password protected file that is saved on your web site.

The form does NOT place items in a 'cart' for later check out, nor does it automatically total the cost for the items checked. For those smaller sites that do not have a large inventory to sell from, this feature is recommended.
HTML Site Design does offer a secure 'Shopping Cart'. To find out about our shopping cart option, please use the above link or click on the button to your left. When asking about the shopping cart, don't forget to include the number of items that you will be selling through your web site.
NOTE - The shopping cart feature does not incur any user fees.

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Pick the item that you would like to purchase and click in the "Select" box in that row. Then fill in the quantity desired by typing any amount from 1 to 999. When your order is submitted, we'll total up the purchase, submit the charges to your credit card and ship your order within 72 hours.
NOTE - this form is for demonstration purposes only. You are NOT ordering anything. When you get to the Thank You page, it will include a link to the file that is generated by this form. Please do not supply REAL personal data in this form since the saved file is available to anyone that tests the functionality of this form.

Picture	Description	Price	Select	Quantity
	Fine thread, heat treated bolt, priced per 10 ct box	12.95
	Leisure Time^® Chemicals to keep your Spa looking its best, per 18 oz bottle	14.95
	500 ct, Tylenol^® - Extra Strength Arthritis Formula	5.87
	Skittles^® - Tropical Fruit, 10 oz bag	1.97
	Western Digital^® 6.4 gig EIDE Hard Drive	149.50
	Optic Pro^®, 9630 30 bit scanner	119.00
	Office Lamp, Mod 574 w/Green Shade	29.39
	Office Chair Mod A45c wo/arm rests, swivel casters, dark fabric, stain resistant	79.95
	Canon 620 Color Bubble Jet Printer	139.00
	Campbell's Chicken Noodle Soup^®, per 24ct case	18.96

	Shipping and Handling	5.95

Name:
Address:
City:
State:
Phone #:
E-Mail:

Credit Card:
Number:

Expiration Date:

Your order will be processed within 72 hours of receipt. Please note that Shipping and Handling costs are automatically included for all orders.

Please click the submit button to continue on to view the file that is generated by this form.

The above order form is representative of the type of form that HTML Site Design uses for those customers that prefer not to opt for our secure shopping cart.

Due to the complexity of the form itself, a basic one page order form for up to 25 items is priced at $400.00. This does not include any graphics that would be included in the final page.

If you would like to order our Secure Ordering Form feature, please let us know, so we can discuss the details.

HTML Site Design

515-262-9649

or

E-Mail Us for Information