Secure Order Form Demo


You will note that the normal padlock icon (signifying a secure connection) is absent from this form if you have arrived here via one of the pre-formatted demo product listings, or a navigation link on one of the main pages. This absence is simply a function of the initial setup state of this demo site. If you add your own product listing, youll see that the order form is viewed over a secure server when accessed via that new product. All other links become secure after routine setup.

This text (and the header panel) can be edited to say whatever your client wishes. Typically you might say something like . . .


You will be provided an opportunity to preview and change your order before it is processed. Once submitted, we will confirm your order via email. All orders are normally shipped within 24 hours.

If you have any questions, or prefer to place your order via the phone, you can reach us at 555-555-1111. If you wish, you can fax this order to 555-555-1111 Or mail to Our Company, 123 Anystreet, Our Fair City, State 11111.

Select Products  

QtyItemDescriptionPrice
1  01 Roses For A Special Occassion $79  
each  02 Star Wars On Sale! $47.00  
each  03 Fabulous Holidays in Tahiti $995.00  

Select Shipping Preferences

Priority Mail - No Charge
Fed Ex Next Day - $15.00
Fed Ex International - $28.00
UPS Ground - $10.00
UPS Next Day - $18.00

Enter Customer Information Below

First NameLast Name
Company Name (optional)
Address
City State Postal Code
Country
Phone:

Ship To Address
 Check if shipping address is the same as mailing address above.
First NameLast Name
Company Name (optional)
Address
City State Postal Code
Country
Payment Information

Select Pay Method:
Master Card Discover
Visa Other
American Express
Card NumberExpire
E-Mail Address (required)
Additional Instructions or comments:


You will note that the normal padlock icon (signifying a secure connection) is absent from this form if you have arrived here via one of the pre-formatted demo product listings, or a navigation link on one of the main pages. This absence is simply a function of the initial setup state of this demo site. If you add your own product listing, youll see that the order form is viewed over a secure server when accessed via that new product. All other links become secure after routine setup.

This text (and the header panel) can be edited to say whatever your client wishes. Typically you might say something like . . .


You will be provided an opportunity to preview and change your order before it is processed. Once submitted, we will confirm your order via email. All orders are normally shipped within 24 hours.

If you have any questions, or prefer to place your order via the phone, you can reach us at 555-555-1111. If you wish, you can fax this order to 555-555-1111 Or mail to Our Company, 123 Anystreet, Our Fair City, State 11111.