New Millennium Candle Company/OrderPage

<body topmargin="0" leftmargin="0" bgcolor="#000068" text="#E8CC20" link="#E8CC20" vlink="#E8CC20" alink="#E8CC20"><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td><h1 align="center" style="line-height: 100%; margin-top: -6; margin-bottom: -32"><b><font color="#000068"> New Millennium Candle Company</font></b> </h1> <p align="center"><img border="0" src="_borders/Banner01.gif" width="600" height="90"> </p> <h1 align="center" dir="ltr"> <img border="0" src="_borders/LogoBullet.gif" width="34" height="34"> <marquee style="color: #E8CC20; font-family: Bernhard Modern Roman; font-size: 12pt; font-weight: bold" align="middle" behavior="slide" bgcolor="#000068" width="696" height="35" loop="1">"Lighting the way into the New Millennium . . . from Wausau to the World!"</marquee> <img border="0" src="_borders/LogoBullet.gif" width="34" height="34"> </h1> <p align="center"> <img border="0" src="BD21322_.gif" style="border: 3px outset #E8CC20" width="625" height="2"></p> </td></tr></table><table dir="ltr" border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td valign="top" width="1%"> <p style="line-height: 100%"> </p> </td><td valign="top" width="24"></td><td valign="top"> <p align="center">  </p> <p align="center"> <![if !vml]><img border=0 width=227 height=39 src="Order_Page_files/image001.gif" alt="Artist Profile" v:shapes="_x0000_s1048"><![endif]></p> <p> You may use this web form to send us an inquiry about our products and custom services. All personal information sent on this form will be kept strictly confidential and will not be shared or sold. In the near future we will be able to accept your credit card information for payments and custom order deposits. Please send any orders or inquiries for Jim Lesh's pewter whale tails through the form on that web page. Thank you.</p> <script Language="JavaScript" Type="text/javascript"></script><form method="POST" action="_vti_bin/shtml.exe/Order_Page.htm" onsubmit="return FrontPage_Form1_Validator(this)" language="JavaScript" name="FrontPage_Form1" webbot-action="--WEBBOT-SELF--"> <input TYPE="hidden" NAME="VTI-GROUP" VALUE="0"> <p> <font color="#000068"> </font></p> <p> <b><font color="#E8CC20" size="4">Customer Information </font></b><em> <font color="#FF0000">  </font> <font color="#00FFFF">(*Required Fields)</font></em></p> <table width="315"> <tr><td align="left" width="74"><em><font color="#E8CC20">Name</font><font color="#00FFFF">*</font></em></td> <td width="255"> <input name="Name" value size="35" style="border: 2px inset #E8CC20; "></td></tr> <tr><td align="left" width="74"><em><font color="#E8CC20">Title</font></em></td> <td width="255"> <input name="Title" value size="35" style="border: 2px inset #E8CC20; "></td></tr> <tr><td align="left" width="74"><em><font color="#E8CC20">Company</font></em></td> <td width="255"> <input name="Company" value size="35" style="border: 2px inset #E8CC20; "></td></tr> <tr> <td align="left" width="74"><em><font color="#E8CC20">Address</font><font color="#00FFFF">*</font></em></td> <td width="255"> <input name="Address1" value size="35" style="border: 2px inset #E8CC20; "></td> </tr> <tr> <td align="left" width="74"><em>Apt. #</em></td><td width="255"> <input name="Apt# " value size="35" style="border: 2px inset #E8CC20; "></td> </tr> <tr> <td align="left" width="74"><em>City<font color="#00FFFF">*</font></em></td> <td width="255"> <input name="City" value size="35" style="border: 2px inset #E8CC20; "></td> </tr> <tr><td align="left" width="74"><em>State<font color="#00FFFF">*</font></em></td> <td width="255" bgcolor="#000068"> <select size="1" name="State" style="float: left; border: 2px inset #E8CC20"> <option>Click Your State Here</option> <option>AL - Alabama</option> <option>AK - Alaska</option> <option>AZ - Arizona</option> <option>AR - Arkansas</option> <option>CA - California</option> <option>CO - Colorado</option> <option>CT - Connecticut</option> <option>DE - Delaware</option> <option>DC - District of Columbia</option> <option>FL - Florida</option> <option>GA - Georgia</option> <option>HI - Hawaii</option> <option>ID - Idaho</option> <option>IL - Illinois</option> <option>IN - Indiana</option> <option>IA - Iowa</option> <option>KS - Kansas</option> <option>KY - Kentucky</option> <option>LA - Louisiana</option> <option>ME - Maine</option> <option>MD - Maryland</option> <option>MA - Massachusetts</option> <option>MI - Michigan</option> <option>MN - Minnesota</option> <option>MS - Mississippi</option> <option>MO - Missouri</option> <option>MT - Montana</option> <option>NE - Nebraska</option> <option>NV - Nevada</option> <option>NH - New Hamshire</option> <option>NJ - New Jersey</option> <option>NM - New Mexico</option> <option>NY - New York</option> <option>NC - North Carolina</option> <option>ND - North Dakota</option> <option>OH - Ohio</option> <option>OK - Oklahoma</option> <option>OR - Oregon</option> <option>PA - Pennsylvania</option> <option>RI - Rhode Island</option> <option>SC - South Carolina</option> <option>SD - South Dakota</option> <option>TN - Tennessee</option> <option>TX - Texas</option> <option>UT - Utah</option> <option>VT - Vermont</option> <option>VA - Virginia</option> <option>WA - Washington</option> <option>WV - West Virginia</option> <option>WI - Wisconsin</option> <option>WY - Wyoming</option> </select></td></tr> <tr> <td align="left" width="74"><em>Zip Code<font color="#00FFFF">*</font></em></td> <td width="255"> <input name="Zip_Code" value size="35" style="border: 2px inset #E8CC20; " maxlength="10"></td> </tr> <tr><td align="left" width="74"><em><font color="#E8CC20">Telephone</font><font color="#00FFFF">*</font></em></td> <td width="255"> <input name="Telephone" value size="35" style="border: 2px inset #E8CC20; "></td></tr> <tr><td align="left" width="74"><em><font color="#E8CC20">FAX</font></em></td> <td width="255"> <input name="FAX" value size="35" style="border: 2px inset #E8CC20; "></td></tr> <tr><td align="left" width="74"><em><font color="#E8CC20">E-mail</font><font color="#00FFFF">*</font></em></td> <td width="255"> <input name="Email" value size="35" style="border: 2px inset #E8CC20; " maxlength="35"></td></tr> </table> <h3>Request Additional Information Inquiry</h3> <blockquote> <dl> <dt> <textarea name="Comments" rows="10" cols="45" style="border: 4px inset #E8CC20; "></textarea> </dt> <div align="left"> <dt><font size="2">                                       Type request inquiry here.</font></dt> </div> </dl> </blockquote> <h3><font color="#E8CC20">Category</font><em><font color="#00FFFF">*</font></em></h3> <p>        <select name="Category" style="border: 5px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"> <option selected>Click Item Here!</option> <option>Candle Cordials</option> <option>Heart Candles</option> <option>Unity Candles</option> <option>Wedding Candle Sets</option> <option>Candle Holders</option> <option>Candle Casting</option> <option>Pewter Casting</option> <option>Ceramic Casting</option> <option>Candle Repairs</option> </select></p> <p><b><font size="4">Custom Unity Candles, Wedding Candle Sets & Personalized Heart Candles Options </font></b><em> <font color="#00FFFF">(*Required Fields)</font></em></p> <dl> <dt><b><font size="4">         </font>Names</b><em><font color="#00FFFF">*</font></em><b>    </b> <input type="text" name="Brides_Name1" size="15" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1">     <input type="text" name="Grooms_Name2" size="15" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1">      <input type="text" name="Last_Name3" size="25" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1">   </dt> <dt>                                       <font size="2"> Bride                                   Groom                                         Last Name</font></dt> <dt><b>           Wedding Date</b><em><font color="#00FFFF">*</font></em><b>    </b> <input type="text" name="Wedding_Date" size="20" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"></dt> </dl> <p>        <b>Heart Candle Quantity    </b> <input type="text" name="Heart_Candle_Quantity" size="5" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"> <font size="2"> (There is a minimum order of 50 candles required for custom engraving.)</font></p> <blockquote> <dl> <dt> <b>Candle Color</b><em><font color="#00FFFF">*</font></em></dt> <dt> <input type="radio" name="Candle_Color" value="Ivory" checked>Ivory    <input type="radio" name="Candle_Color" value="White">White    <input type="radio" name="Candle_Color" value="Custom">Custom <input type="text" name="Custom_Candle_Color" size="28" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"><font size="2"> (Type custom color here)</font></dt> <dd> </dd> <dt><b>Unity Candle Monogramming Options</b><em><font color="#00FFFF">*</font></em></dt> <dt> <input type="radio" name="Candle_Monogramming" value="Single Initial" checked>Single Initial    <input type="radio" name="Candle_Monogramming" value="Three Initials">Three Initials    <input type="radio" name="Candle_Monogramming" value="Custom Monogram">Custom Monogram</dt> </dl> <dl> <dt><b>            Tapered Lighting Candles Monogramming Options</b><em><font color="#00FFFF">*</font></em></dt> <dt>             <input type="radio" name="Tapered_Candles_Monogramming" value="Single Initial" checked>Single Initial    <input type="radio" name="Tapered_Candles_Monogramming" value="Dual Initials">Dual Initials    <input type="radio" name="Tapered_Candles_Monogramming" value="Last Names">Last Names</dt> <dd> </dd> <dt><b>Custom Script Style</b></dt> <dt> NMCC custom font number:   <input type="text" name="Custom_Script_Style" size="11" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1" value="NMCCfont-" maxlength="11"></dt> <dd> </dd> <dt><b>Script Color</b><em><font color="#00FFFF">*</font></em></dt> <dt> <input type="radio" name="Script_Color" value="Gold" checked>Gold    <input type="radio" name="Script_Color" value="Silver">Silver    <input type="radio" name="Script_Color" value="Custom">Custom <input type="text" name="Custom_Script_Color" size="28" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"><font size="2"> (Type custom color here)</font></dt> <dd> </dd> <dt><b>Unity Candle Top Edge Profile</b><em><font color="#00FFFF"> </font></em><b> Options</b><em><font color="#00FFFF">*</font></em></dt> <dt><input type="radio" name="Candle_Edge" value="Sharp" checked>Sharp    <input type="radio" name="Candle_Edge" value="Smooth">Smooth    <input type="radio" name="Candle_Edge" value="Rounded">Round</dt> </dl> <dl> <dt><b>Candle Fragrance</b><em><font color="#00FFFF">*</font></em></dt> <dt> <input type="radio" name="Fragrance" value="Unscented" checked>Unscented    <input type="radio" name="Fragrance" value="Scented">Scented <input type="text" name="Custom_Fragrance" size="28" style="border: 2px inset #E8CC20; padding-left: 4; padding-right: 4; padding-top: 1; padding-bottom: 1"> <font size="2">(Type fragrance name here)</font></dt> <dt> </dt> <div align="left"> <dt><font size="2">       </font></dt> </div> <dd> <dd> <p align="left"> </dd> </dd> </dl> </blockquote> <p align="center"><font size="4"><b>       </b></font> <input type="SUBMIT" value="Submit Order" style="border: 4px outset #E8CC20; ">          <input type="RESET" value="Reset Form" style="border: 4px outset #E8CC20; "> </p> <p> </p> <p align="center">Thank You! We will reply as soon as possible.</p> </form> </td></tr></table><table border="0" cellpadding="0" cellspacing="0" width="100%"><tr><td> <p align="center"> <img border="0" src="BD21322_.gif" style="border: 3px outset #E8CC20" width="625" height="2"></p> <p align="center"><font color="#E8CC20">         [<a href="HomePage.htm" target="_top" style="text-decoration: none"><b>Home</b></a>] [<a href="News_1.htm" target="_top" style="text-decoration: none"><b>News</b></a>] [<u><a href="Newpicpage_1.htm" target="_top" style="text-decoration: none"><b>New Pics</b></a></u>] [<b><a href="Products_Page_Main.htm" target="_top" style="text-decoration: none">Products</a></b>] [<a href="Services_Custom_Casting%20.htm" target="_top" style="text-decoration: none"><b>Services</b></a>] [<b>Dealers</b>] [<u><a href="Contents_Page.htm" target="_top" style="text-decoration: none"><b>Contents</b></a></u>] [<b><a target="_top" style="text-decoration: none" href="Search_Page.htm">Search</a></b>] [<a href="Order_Page.htm" style="text-decoration: none"><b>Order</b></a>]</font></p> <dl> <div align="center"> <center> <dt style="line-height: 100%"> <font color="#E8CC20" size="2"> Send e- mail inquires to:</font></dt> </center> </div> <div align="center"> <center> <dt style="line-height: 150%"> <font color="#E8CC20" size="2">   <b> <a href="mailto:cuervo_enterprises@hotmail.com">customer_services@lightanew.com</a></b>  for consumer questions about online orders.</font></dt> </center> </div> <div align="center"> <center> <dt style="line-height: 150%"> <font color="#E8CC20" size="2">  </font><font size="2"> <font color="#E8CC20">              </font>           </font></dt> </center> </div> </dl> <p style="line-height: 100%" align="left"> </p> <p style="line-height: 100%" align="left"> </p> <p style="line-height: 100%" align="left"> </p> <p style="line-height: 100%" align="center"> </p> <p style="line-height: 100%" align="center"> </p> <p style="line-height: 100%" align="left"> </p> <p style="line-height: 100%" align="left"> </p> <p style="line-height: 100%" align="left"> </p> <blockquote> <blockquote> <dl> <div align="center"> <center> <dt style="line-height: 100%"><font size="2">   </font><strong><font color="#E8CC20" size="1"><img src="_vti_bin/fpcount.exe/?Page=_borders/bottom.htm|Image=0|Digits=4" alt="Hit Counter"></font></strong><font color="#E8CC20"><br> <font size="2">                      </font></font><font size="2" color="#E8CC20">                   </font><strong><font color="#E8CC20" size="2">       </font></strong></dt> </center> </div> </dl> <p style="line-height: 100%" align="left"> </p> <dl> <div align="center"> <center> <dt style="line-height: 100%"><font color="#0000FF"><b><font size="1"> All Images and Text  </font></b><font size="4"><b>© </b></font><b><font size="1"> Copyright 2000 - 2008 Cuervo Enterprises - All Rights Reserved</font></b></font></dt> </center> </div> </dl> </blockquote> </blockquote> </td></tr></table></body>