Barclay Labs Natural Treasures Barclay Labs Order Form Please print this form to order  

Ordered By Ship To (if other than ordered by)
Name:<%=Request.Form("OrderName")%> Name:<%=Request.Form("ShipToName")%>
Address (No P.O. Boxes please) 
<%=Request.Form("Address1")%>
<%=Request.form("Address2")%>
Address (No P.O. Boxes please) 
<%=Request.Form("ShipToAddress1")%>
<%Request.Form("ShipToAddress2")%>
City: <%Request.Form("City")%>
State: <%=Request.Form("State")%>
Zip: <%=Request.Form("Zip")%>
City: <%=Request.Form("ShipToCity") %> 
State: <%=Request.Form("ShipToState")%> 
Zip: <%=Request.Form("ShipToZip")%>
Phone: <%=Request.Form("Phone")%> Phone: <%=Request.Form("ShipToPhone")%>
Customer Number (if known): <%=Request.Form("CustomerNumber")%> Customer Number (if known):<%=Request.Form("ShipToCustomerNumber")%>

 

Order Code Product Description Quantity Price Each Total
<%=Request.Form("OrderCode1")%> <%=Request.Form("ProductDesc1")%> <%=Request.Form("Q1")%> <%=Request.Form("Price1")%> <%=Request.Form("Total1")%>
<%=Request.Form("OrderCode2")%> <%=Request.Form("ProductDesc2")%> <%=Request.Form("Q2")%> <%=Request.Form("Price2")%> <%=Request.Form("Total2")%>
<%=Request.Form("OrderCode3")%> <%=Request.Form("ProductDesc3") %> <%=Request.Form("Q3")%> <%=Request.Form("Price3")%> <%=Request.Form("Total3")%>
<%=Request.Form("OrderCode4")%> <%=Request.Form("ProductDesc4")%> <%=Request.Form("Q4")%> <%=Request.Form("Price4")%> <%=Request.Form("Total4")%>
<%=Request.Form("OrderCode5")%> <%=Request.Form("ProductDesc5")%> <%=Request.Form("Q5")%> <%=Request.Form("Price5")%> <%=Request.Form("Total5")%>
<%=Request.Form("OrderCode6")%> <%=Request.Form("ProductDesc6")%> <%=Request.Form("Q6")%> <%=Request.Form("Price6")%> <%=Request.Form("Total6")%>
<%=Request.Form("OrderCode7")%> <%=Request.Form("ProductDesc7")%> <%=Request.Form("Q7")%> <%=Request.Form("Price7")%> <%=Request.Form("Total7")%>
<%=Request.Form("OrderCode8")%> <%=Request.Form("ProductDesc8")%> <%=Request.Form("Q8")%> <%=Request.Form("Price8")%> <%=Request.Form("Total8")%>

  

Subtotal <%dim SubT dim Total1 dim Total2 dim Total3 dim Total4 dim Total5 dim total6 dim Total7 dim Total8 Total1 = CCur(Request.Form("Total1")) response.write(vartype(total1) & "
") response.write Total1 & "
" Total2 = CCur(Request.Form("Total2")) response.write Total2 & "
" response.write (Total1 + Total2) & "
" response.write (27.50 + 100.00) & "
" Total3 = CCur(Request.Form("Total3")) Total4 = CCur(Request.Form("Total4")) Total5 = CCur(Request.Form("Total5")) Total6 = CCur(Request.Form("Total6")) Total7 = CCur(Request.Form("Total7")) Total8 = CCur(Request.Form("Total8")) SubT = Total1 SubT = SubT + Total2 Response.write SubT%>
TAX -California Residents Only - add in 7.25% <%=Request.Form("CASalesTax")%>
Shipping Charges - see below <%=Request.Form("ShippingCharges")%>
Total Enclosed <%=Request.Form("GrandTotal")%>

    


Barclay Labs
4780 Caterpiller Road, Unit A
Redding, CA  96003
(530) 244-4460

Open Mon - Thurs, 9 - 4 PST

Toll Free Order Line: (800) 845-4460
Fax: (530) 244-2924
E-Mail: payment9@massage-oil.com

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URL:http://www.massage-oil.com