<% ' FP_ASP ASP Automatically generated by a Frontpage Component. Do not Edit. On Error Resume Next Session("FP_OldCodePage") = Session.CodePage Session("FP_OldLCID") = Session.LCID Session.CodePage = 1252 Err.Clear strErrorUrl = "" If Request.ServerVariables("REQUEST_METHOD") = "POST" Then If Request.Form("VTI-GROUP") = "0" Then Err.Clear Set fp_conn = Server.CreateObject("ADODB.Connection") FP_DumpError strErrorUrl, "Cannot create connection" Set fp_rs = Server.CreateObject("ADODB.Recordset") FP_DumpError strErrorUrl, "Cannot create record set" fp_conn.Open Application("orderform_ConnectionString") FP_DumpError strErrorUrl, "Cannot open database" fp_rs.Open "Results", fp_conn, 1, 3, 2 ' adOpenKeySet, adLockOptimistic, adCmdTable FP_DumpError strErrorUrl, "Cannot open record set" fp_rs.AddNew FP_DumpError strErrorUrl, "Cannot add new record set to the database" Dim arFormFields0(62) Dim arFormDBFields0(62) Dim arFormValues0(62) arFormFields0(0) = "T23" arFormDBFields0(0) = "T23" arFormValues0(0) = Request("T23") arFormFields0(1) = "T12" arFormDBFields0(1) = "T12" arFormValues0(1) = Request("T12") arFormFields0(2) = "T34" arFormDBFields0(2) = "T34" arFormValues0(2) = Request("T34") arFormFields0(3) = "T2" arFormDBFields0(3) = "T2" arFormValues0(3) = Request("T2") arFormFields0(4) = "Item3" arFormDBFields0(4) = "Item3" arFormValues0(4) = Request("Item3") arFormFields0(5) = "Quan1" arFormDBFields0(5) = "Quan1" arFormValues0(5) = Request("Quan1") arFormFields0(6) = "Total1" arFormDBFields0(6) = "Total1" arFormValues0(6) = Request("Total1") arFormFields0(7) = "T24" arFormDBFields0(7) = "T24" arFormValues0(7) = Request("T24") arFormFields0(8) = "T13" arFormDBFields0(8) = "T13" arFormValues0(8) = Request("T13") arFormFields0(9) = "T35" arFormDBFields0(9) = "T35" arFormValues0(9) = Request("T35") arFormFields0(10) = "T3" arFormDBFields0(10) = "T3" arFormValues0(10) = Request("T3") arFormFields0(11) = "Item4" arFormDBFields0(11) = "Item4" arFormValues0(11) = Request("Item4") arFormFields0(12) = "Quan2" arFormDBFields0(12) = "Quan2" arFormValues0(12) = Request("Quan2") arFormFields0(13) = "T25" arFormDBFields0(13) = "T25" arFormValues0(13) = Request("T25") arFormFields0(14) = "T14" arFormDBFields0(14) = "T14" arFormValues0(14) = Request("T14") arFormFields0(15) = "T4" arFormDBFields0(15) = "T4" arFormValues0(15) = Request("T4") arFormFields0(16) = "Item5" arFormDBFields0(16) = "Item5" arFormValues0(16) = Request("Item5") arFormFields0(17) = "description1" arFormDBFields0(17) = "description1" arFormValues0(17) = Request("description1") arFormFields0(18) = "Quan3" arFormDBFields0(18) = "Quan3" arFormValues0(18) = Request("Quan3") arFormFields0(19) = "cost1" arFormDBFields0(19) = "cost1" arFormValues0(19) = Request("cost1") arFormFields0(20) = "T26" arFormDBFields0(20) = "T26" arFormValues0(20) = Request("T26") arFormFields0(21) = "T15" arFormDBFields0(21) = "T15" arFormValues0(21) = Request("T15") arFormFields0(22) = "T5" arFormDBFields0(22) = "T5" arFormValues0(22) = Request("T5") arFormFields0(23) = "description2" arFormDBFields0(23) = "description2" arFormValues0(23) = Request("description2") arFormFields0(24) = "Quan4" arFormDBFields0(24) = "Quan4" arFormValues0(24) = Request("Quan4") arFormFields0(25) = "T16" arFormDBFields0(25) = "T16" arFormValues0(25) = Request("T16") arFormFields0(26) = "T27" arFormDBFields0(26) = "T27" arFormValues0(26) = Request("T27") arFormFields0(27) = "T6" arFormDBFields0(27) = "T6" arFormValues0(27) = Request("T6") arFormFields0(28) = "description3" arFormDBFields0(28) = "description3" arFormValues0(28) = Request("description3") arFormFields0(29) = "Quan5" arFormDBFields0(29) = "Quan5" arFormValues0(29) = Request("Quan5") arFormFields0(30) = "T17" arFormDBFields0(30) = "T17" arFormValues0(30) = Request("T17") arFormFields0(31) = "T28" arFormDBFields0(31) = "T28" arFormValues0(31) = Request("T28") arFormFields0(32) = "T7" arFormDBFields0(32) = "T7" arFormValues0(32) = Request("T7") arFormFields0(33) = "description4" arFormDBFields0(33) = "description4" arFormValues0(33) = Request("description4") arFormFields0(34) = "T18" arFormDBFields0(34) = "T18" arFormValues0(34) = Request("T18") arFormFields0(35) = "T29" arFormDBFields0(35) = "T29" arFormValues0(35) = Request("T29") arFormFields0(36) = "T8" arFormDBFields0(36) = "T8" arFormValues0(36) = Request("T8") arFormFields0(37) = "description5" arFormDBFields0(37) = "description5" arFormValues0(37) = Request("description5") arFormFields0(38) = "T19" arFormDBFields0(38) = "T19" arFormValues0(38) = Request("T19") arFormFields0(39) = "T9" arFormDBFields0(39) = "T9" arFormValues0(39) = Request("T9") arFormFields0(40) = "email" arFormDBFields0(40) = "email" arFormValues0(40) = Request("email") arFormFields0(41) = "Tele" arFormDBFields0(41) = "Tele" arFormValues0(41) = Request("Tele") arFormFields0(42) = "CityStete" arFormDBFields0(42) = "CityStete" arFormValues0(42) = Request("CityStete") arFormFields0(43) = "special1" arFormDBFields0(43) = "special1" arFormValues0(43) = Request("special1") arFormFields0(44) = "special2" arFormDBFields0(44) = "special2" arFormValues0(44) = Request("special2") arFormFields0(45) = "T30" arFormDBFields0(45) = "T30" arFormValues0(45) = Request("T30") arFormFields0(46) = "name" arFormDBFields0(46) = "name" arFormValues0(46) = Request("name") arFormFields0(47) = "special3" arFormDBFields0(47) = "special3" arFormValues0(47) = Request("special3") arFormFields0(48) = "T31" arFormDBFields0(48) = "T31" arFormValues0(48) = Request("T31") arFormFields0(49) = "T20" arFormDBFields0(49) = "T20" arFormValues0(49) = Request("T20") arFormFields0(50) = "item2" arFormDBFields0(50) = "item2" arFormValues0(50) = Request("item2") arFormFields0(51) = "special4" arFormDBFields0(51) = "special4" arFormValues0(51) = Request("special4") arFormFields0(52) = "T21" arFormDBFields0(52) = "T21" arFormValues0(52) = Request("T21") arFormFields0(53) = "T32" arFormDBFields0(53) = "T32" arFormValues0(53) = Request("T32") arFormFields0(54) = "T10" arFormDBFields0(54) = "T10" arFormValues0(54) = Request("T10") arFormFields0(55) = "Address" arFormDBFields0(55) = "Address" arFormValues0(55) = Request("Address") arFormFields0(56) = "Item1" arFormDBFields0(56) = "Item1" arFormValues0(56) = Request("Item1") arFormFields0(57) = "special5" arFormDBFields0(57) = "special5" arFormValues0(57) = Request("special5") arFormFields0(58) = "T11" arFormDBFields0(58) = "T11" arFormValues0(58) = Request("T11") arFormFields0(59) = "T22" arFormDBFields0(59) = "T22" arFormValues0(59) = Request("T22") arFormFields0(60) = "T33" arFormDBFields0(60) = "T33" arFormValues0(60) = Request("T33") arFormFields0(61) = "T1" arFormDBFields0(61) = "T1" arFormValues0(61) = Request("T1") FP_SaveFormFields fp_rs, arFormFields0, arFormDBFields0 If Request.ServerVariables("REMOTE_HOST") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_HOST"), "Remote_computer_name" End If If Request.ServerVariables("HTTP_USER_AGENT") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("HTTP_USER_AGENT"), "Browser_type" End If FP_SaveFieldToDB fp_rs, Now, "Timestamp" If Request.ServerVariables("REMOTE_USER") <> "" Then FP_SaveFieldToDB fp_rs, Request.ServerVariables("REMOTE_USER"), "User_name" End If fp_rs.Update FP_DumpError strErrorUrl, "Cannot update the database" fp_rs.Close fp_conn.Close FP_FormConfirmation "text/html; charset=windows-1252",_ "Form Confirmation",_ "Thank you for submitting the following information:",_ "orderform.htm",_ "Return to the form." End If End If Session.CodePage = Session("FP_OldCodePage") Session.LCID = Session("FP_OldLCID") %> Orderform

 

Use this form for balloon merchandise

Balloons Galore

orders.balloonsgalore@gmail.com

Mail Order and Telephone Orders

Custom Order Form

Please call 712-255-7068 or 712-233-1872

$15.00 minimum on credit card orders

for credit card mail orders we will call you for your credit card information

From our web pages, select the photograph(s) you wish to use on your order.

Enter the photograph(s) number in the item number column. If you are

supplying your own photograph please tell us in the special instruction box.

Give us an description of the item you're ordering, (magnet, note cards, letter opener, key tag.)

Fill in the blanks, print, and send      easy 1, 2, 3

Item # Item Description Quantity ordered Cost each Total $

Iowa residents add 7% sales taxes Wisconsin residents add 5.5% sales taxes

Special instructions (photograph information, envelope color, note card printing, etc.)

Shipping information

Name
Address
City, State Zip
Telephone
e-mail

 

Sent this form to
Steve Palash
Balloons Galore
2529 Rebecca St
Sioux City, Iowa 51103