<%@ Language=VBScript %> <% Dim strCookie, cookieArray, arraySize, intCounter strCookie = Request.Cookies("Purchase") cookieArray = Split(strCookie, ",", -1, 1) arraySize = UBound(cookieArray) Dim objConn, ObjRS, strQ, strConnection, blnHighlightRow Set objConn = Server.CreateObject("ADODB.Connection") strConnection = "Provider=Microsoft.Jet.OLEDB.4.0;Data Source=D:\GeneralAccounts\sherba\htdocs\sherba.mdb" objConn.Open strConnection Set objRS = Server.CreateObject("ADODB.Recordset") Set objRS.ActiveConnection = objConn %> Sherba - Order Form
As an added convenience for our valued customers we have included this order form with our new price list.
Contact:
Bill To Address: Ship To Address:
Purchase Order Number: Telephone Number:
Credit Card Number: Fax Number:
Your Order:
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We Gladly Accept

Visa International

[MasterCard International]

American Express

As Payment For Services.
Mail Orders to: Fax Orders to: Phone Orders to:

Sherba Analytical Lab Products

P.O. BOX 880

New Port Richey, FL   34656

 1(727) 844-3613

1(800) 228-5085

or

1(727) 849-9456

Please make Checks Payable to:

Sherba Analytical Lab Products, Inc.