<!-- saved from url=(0022)
http://internet.e-mail -->
<title>Plant's Order Form</title>
<LINK REL=stylesheet TYPE="text/css" HREF="ext_style_sheet.css">
<SCRIPT LANGUAGE="JavaScript">
function verify(){
form1 = document.theForm
if (form1.requiredemail.value == ""){
alert("Please, fill the Email field...")
form1.requiredemail.focus()
return false
}
if (form1.requiredemail.value.indexOf('@', 0) == -1 || form1.requiredemail.value.indexOf('.', 0) == -1){
alert("This Email in not valid...")
form1.requiredemail.focus()
return false
}
if (form1.requiredname.value == ""){
alert("Please, fill the Name field...")
form1.requiredname.focus()
return false
}
if (form1.requiredname.value == ""){
alert("Please, fill the Company field...")
form1.requiredcompany.focus()
return false
}
if (form1.requiredaddress.value == ""){
alert("Please, fill the Address field...")
form1.requiredaddress.focus()
return false
}
if (form1.requiredcity.value == ""){
alert("Please, fill the City field...")
form1.requiredcity.focus()
return false
}
if (form1.requiredstate.value == ""){
alert("Please, fill the State field...")
form1.requiredstate.focus()
return false
}
if (form1.requiredzip.value == ""){
alert("Please, fill the Zip field...")
form1.requiredzip.focus()
return false
}
if (form1.requiredphone1.value == ""){
alert("Please, fill the Primary Phone Number field...")
form1.requiredphone1.focus()
return false
}
if (form1.requiredphone2.value == ""){
alert("Please, fill the Secondary Phone Number field...")
form1.requiredphone2.focus()
return false
}
if (form1.requiredcard.value == ""){
alert("Please, fill the Credit Card field...")
form1.requiredcard.focus()
return false
}
if (form1.requiredcard.value.length !== 16){
alert("The Credit Card Number is not valid...")
form1.requiredcard.focus()
return false
}
}
function validate(string)
{ if (!string)
return false;
var Chars = "0123456789";
for (var i = 0; i < string.length; i++)
{
if (Chars.indexOf(string.charAt(i)) == -1) return false;}
return true;
}
function CheckChoice(whichbox)
{
with (whichbox.form)
{
if (whichbox.type == "radio")
{
hiddentotal.value = eval(hiddentotal.value) - eval(hiddenpriorradio.value);
hiddenpriorradio.value = eval(whichbox.price);
hiddentotal.value = eval(hiddentotal.value) + eval(whichbox.price);
}
else
{
if (whichbox.checked == false)
{ hiddentotal.value = eval(hiddentotal.value) - eval(whichbox.value); }
else { hiddentotal.value = eval(hiddentotal.value) + eval(whichbox.value); }
}
if (hiddentotal.value < 0)
{
InitForm();
}
return(formatCurrency(hiddentotal.value));
}
}
function formatCurrency(num)
{
num = num.toString().replace(/\$|\,/g,'');
if(isNaN(num))
num = "0";
sign = (num == (num = Math.abs(num)));
num = Math.floor(num*100+0.50000000001);
cents = num%100;
num = Math.floor(num/100).toString();
if(cents<10)
cents = "0" + cents;
for (var i = 0; i < Math.floor((num.length-(1+i))/3); i++)
num = num.substring(0,num.length-(4*i+3))+','+
num.substring(num.length-(4*i+3));
return (((sign)?'':'-') + '$' + num + '.' + cents);
}
function InitForm()
{
document.myform.total.value='$0';
document.myform.hiddentotal.value=0;
document.myform.hiddenpriorradio.value=0;
document.myform2.total.value='$0';
document.myform2.hiddentotal.value=0;
document.myform2.hiddenpriorradio.value=0;
document.myform2.hiddenpriorradio.value=0;
for (xx=0; xx < document.myform.elements.length; xx++)
{
if (document.myform.elements[xx].type == 'checkbox' | document.myform.elements[xx].type == 'radio')
{
document.myform.elements[xx].checked = false;
}
}
for (xx=0; xx < document.myform2.elements.length; xx++)
{
if (document.myform2.elements[xx].type == 'checkbox' | document.myform2.elements[xx].type == 'radio')
{
document.myform2.elements[xx].checked = false;
}
}
}
</script>
<SCRIPT language="JavaScript">
var pic_width=40;
var pic_height=30;
var delay=2000;
if (document.images)
{
pic1= new Image(pic_width,pic_height);
pic1.src="../images/visa.jpe";
pic2= new Image(pic_width,pic_height);
pic2.src="../images/master.jpe";
pic3= new Image(pic_width,pic_height);
pic3.src="../images/amex.jpe";
pic4= new Image(pic_width,pic_height);
pic4.src="../images/tfb.jpe";
}
var pics= new Array(4)
pics[0]=pic1.src;
pics[1]=pic2.src;
pics[2]=pic3.src;
pics[3]=pic4.src;
var numpics=4;
var thenum=0;
imgName="img1";
function change_it()
{
if (document.images)
{
document.write("<IMG SRC='"+pics[thenum]+"' border='0' width='"+pic_width+"' height='"+pic_height+"' name='img1'>\n");
setTimeout('change_it2()',delay);
}
}
function change_it2()
{
var x=0;
thenum+=1;
if (thenum>numpics-1)
thenum=0;
document[imgName].src=pics[thenum];
x+=1;
setTimeout('change_it2()',delay);
}
</SCRIPT>
</head>
<BODY background="../images/back1.gif" leftmargin="0" topmargin="0" onLoad="startPix()">
<form method="POST" name="theForm" onSubmit="return verify()" action="../frames/construction.htm">
<h2>Welcome! Please place your order.</h2>
<table border=1 bordercolor=#efefef cellSpaceing=0 cellPadding=0 width=600>
<tr><td>
<table border="0" width="600" cellspacing="2" cellpadding="4">
<tr bgcolor="#CCCCCC"><td width="595" colspan="2"><strong><center><P>
Personal Contact Information</big></center></strong>
</td></tr>
<tr valign="top" align="center">
<td width="164" bgcolor="#EFEFEF" align="left"><strong>
Email address</strong><br> e.g., joecool@aol.com
</td>
<td class="tabhead1" width="411" align="left">
<input type="text" name="requiredemail" size="33" maxlength="63"> *
<p style="font-family: arial, sans serif; font-size: 8pt; color:#FF0000">
Note: In order to complete registration, we'll send a confirmation message to the email address you enter above.
<p style="font-family: arial, sans serif; font-size: 8pt; color:#000000">
<br>Be sure to include your "@serviceprovider.com" domain.
<tr valign="top" align="center">
<td class="text" width="164" bgcolor="#EFEFEF" align="left"><strong>
Full name</strong><br>e.g., John H. Doe</td>
<td width="411" bgcolor="#EFEFEF" align="left">
<table border="0" cellspacing="1" cellpadding="1"><tr><td>
<script type="text/javascript">
if(document.cookie !=""){
document.write('<input type="text" name="requiredname" size="40" maxlength="64" value="+document.cookie.split("=")[1]">')
}else{
document.write('<input type="text" name="requiredname" size="40" maxlength="64" value="">')
}
</script>
</td>
<td class="tabhead1">*
</td></table>
</td>
<tr valign="top" align="center">
<td class="text" align="left"><strong>
Company</strong>
</td>
<td width="411" bgcolor="#EFEFEF" align="left">
<input type="text" name="requiredcompany" size="33" maxlength="63" value=""></td></tr>
<tr valign="top" align="center">
<td class="text" width="164" bgcolor="#EFEFEF" align="left"><strong>
Address</strong></td>
<td class="tabhead1" width="411" align="left">
<input type="text" name="requiredaddress" size="33" maxlength="63" value="">
*
</td></tr>
<tr valign="top" align="center">
<td class="text" width="164" align="left"><strong>
City</strong>
</td>
<td class="tabhead1" width="411" align="left">
<input type="text" name="requiredcity" size="33" maxlength="63" value="">
*</td></tr>
<tr valign="top" align="center">
<td class="text" width="164" align="left"><strong>
State/Territory</strong></td>
<td class="tabhead1" width="411" align="left"><input type="text" name="requiredstate" size="33" maxlength="33" value="">
*</td></tr>
<tr valign="top" align="center">
<td class="text" width="164" align="left"><strong>
Postal Code</strong></td>
<td class="tabhead1" width="411" align="left"><input type="text" name="requiredzip" size="33" maxlength="12" value="">
*</td></tr>
<tr valign="top" align="center">
<td class="text" width="164" align="left"><strong>
Primary phone number</strong><br>
</td>
<td class="tabhead1" width="411" align="left"><input type="text" name="requiredphone1" size="16" maxlength="16 "value="" onChange="if (!validate(this.value)) alert('Not valid type of phone number for your primary')">
*</td></tr>
<tr valign="top" align="center">
<td class="text" align="left"><strong>
Secondary phone number</strong></td>
<td class="tabhead1" width="411" align="left"><input type="text" name="requiredphone2" size="16" maxlength="16" value="" onChange="if (!validate(this.value)) alert('Not valid type of phone number for your secondary')">
<tr valign="top" align="center">
<td class="text" align="left"><strong>
Credit Card Number</strong></td>
<td class="tabhead1" width="411" align="left"><input type="text" name="requiredcard" size="16" maxlength="16" value="" onKeyPress="return Tecla(event)">*
<p style="font-family: arial, sans serif; font-size: 8pt; color:#FF0000">
* Please note that we only accept Visa,Master,American Express and TFB *
<SCRIPT language="JavaScript">
change_it()
</SCRIPT>
</td></tr>
</table>
<table width="100%" border=0>
<tr bgcolor="#CCCCCC"><td width="595" colspan="2"><strong><center><P>
Please choose the type of plants you need to order</big></center></strong>
</table>
<table width="100%" border=0>
<tr class="list2" >
<form method="POST" name="myform">
<font face=Arial size=2>
<input type="checkbox" name="everlasting" value=6.00 onclick="this.form.total.value=CheckChoice(this);">
Everlasting Daisy 6in Pots $6.00<br>
<input type="checkbox" name="corea" value=5.00 onclick="this.form.total.value=CheckChoice(this);">
Corea 6in Pots $5.00<br>
<input type="checkbox" name="brunonia" value=6.00 onclick="this.form.total.value=CheckChoice(this);">
Brunonia (Blue Pincushions) 6in Pots $6.00<br>
<input type="checkbox" name="wahlenbergia" value=7.00 onclick="this.form.total.value=CheckChoice(this);">
Wahlenbergia (Bluebell) 6in Pots $7.00<br>
<input type="checkbox" name="harkness" value=14.50 onclick="this.form.total.value=CheckChoice(this);">
Callistemon Harkness (Bottlebrush) 6in Pots $14.50<br>
<input type="checkbox" name="hibiscus" value=14.00 onclick="this.form.total.value=CheckChoice(this);">
Hibiscus Inca Rose 6in Pots $14.00<br>
<input type="checkbox" name="lily" value=16.00 onclick="this.form.total.value=CheckChoice(this);">
Liriope muscari Royal Purple (Lily Turf) 6in Pots $16.00<br>
<input type="checkbox" name="olive" value=13.00 onclick="this.form.total.value=CheckChoice(this);">
Osmanthus (Sweet Olive) 6in Pots $13.00<br>
<input type="checkbox" name="Tetratheca" value=10.00 onclick="this.form.total.value=CheckChoice(this);">
Tetratheca shiressii 6in Pots $10.00<br>
<input type="checkbox" name="Dampieria" value=16.00 onclick="this.form.total.value=CheckChoice(this);">
Dampieria purpurea 6in Pots $16.00<br>
<input type="hidden" name="hiddentotal" value=0>
<input type="hidden" name="hiddenpriorradio" value=0><br>
Your total is: <input type="text" name="total" readonly onFocus="this.blur();">
<br>
(Note: Total can not be changed by the visitor.)
</tr>
</table>
</table>
<table bother="0" >
<tr><td valign="top" height="100" align="left"><p>
<left><p><input type="submit" value="Submit"></left></td></tr></table>
</form>
</html>
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