Quit for Life Order Form

<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/1999/REC-html401-19991224/loose.dtd"> <html> <head> <title>InterPersonalNet</title> <link rel="stylesheet" href="/decor/default.css.php"> <script language="JavaScript"> function PopWin(p_Where, p_Width, p_Height, p_Name) { if (p_Width == "") {p_Width = 560} if (p_Height == "") {p_Height = 400} if (p_Name == "") {p_Name = "fetch_pop"} var win=open(p_Where, p_Name, "menubar=yes,toolbar=no,width=" + p_Width + ",height=" + p_Height + ",resizable=1,scrollbars=1"); win.focus(); } </Script></head> <body text="#000000" link="#666699" vlink="#666699" alink="#666699" bgcolor="#FFFFFF"> <table summary="page layout" border="0" width="595" cellspacing="5" cellpadding="2"> <tr> <td colspan="2" valign="top"> <img src="../decor/ipn-logo.gif" alt="interpersonalnet logo" width="595" height="110"> </td> </tr> <tr> <td colspan="2"> <table border="0" summary="page layout" width="595" cellspacing="5" cellpadding="2"> <tr><th align="left">Item</th><th>Price</th><th>Shipping</th><th></th></tr> <tr> <td valign="top"> Quit for Life:<br> A Clinical Guide to Smoking Cessation </td> <td valign="top" align="right"> $16.95 </td> <td valign="top" align="right"> $5.00 </td> <td valign="top" align="right"> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="hidden" name="item_name" value="Quit for Life: A Clinical Guide to Smoking Cessation"> <input type="hidden" name="item_number" value="Q4L-Book"> <input type="hidden" name="amount" value="16.95"> <input type="hidden" name="shipping" value="5.00"> <input type="hidden" name="return" value="http://interpersonalnet.com/quitforlife/thankyou.html"> <input type="hidden" name="cancel_return" value="http://interpersonalnet.com/quitforlife/cancel.html"> <input type="hidden" name="no_note" value="1"> <input type="hidden" name="currency_code" value="USD"> <input type="hidden" name="lc" value="US"> <input type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="add" value="1"> </form> </td> </tr> <tr> <td valign="top"> Relaxation Training & Hypnosis Compact Disc (CD) </td> <td valign="top" align="right"> $11.95 </td> <td valign="top" align="right"> $4.00 </td> <td valign="top" align="right"> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="hidden" name="item_name" value="Relaxation Training & Hypnosis Compact Disc (CD)"> <input type="hidden" name="item_number" value="Q4L-CD"> <input type="hidden" name="amount" value="11.95"> <input type="hidden" name="shipping" value="4.00"> <input type="hidden" name="return" value="http://interpersonalnet.com/quitforlife/thankyou.html"> <input type="hidden" name="cancel_return" value="http://interpersonalnet.com/quitforlife/cancel.html"> <input type="hidden" name="no_note" value="1"> <input type="hidden" name="currency_code" value="USD"> <input type="hidden" name="lc" value="US"> <input type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="add" value="1"> </form> </td> </tr> <tr> <td valign="top"> Relaxation Training & Hypnosis Audio Tape (Cassette) </td> <td valign="top" align="right"> $11.95 </td> <td valign="top" align="right"> $4.00 </td> <td valign="top" align="right"> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="hidden" name="item_name" value="Relaxation Training & Hypnosis Audio Tape (Cassette)"> <input type="hidden" name="item_number" value="Q4L-Cassette"> <input type="hidden" name="amount" value="11.95"> <input type="hidden" name="shipping" value="4.00"> <input type="hidden" name="return" value="http://interpersonalnet.com/quitforlife/thankyou.html"> <input type="hidden" name="cancel_return" value="http://interpersonalnet.com/quitforlife/cancel.html"> <input type="hidden" name="no_note" value="1"> <input type="hidden" name="currency_code" value="USD"> <input type="hidden" name="lc" value="US"> <input type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="add" value="1"> </form> </td> </tr> <tr> <td valign="top"> Quit for Life Book and CD Together </td> <td valign="top" align="right"> $24.95 </td> <td valign="top" align="right"> $7.00 </td> <td valign="top" align="right"> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="hidden" name="item_name" value="Quit for Life Book and CD Together"> <input type="hidden" name="item_number" value="Q4L-Book&CD"> <input type="hidden" name="amount" value="24.95"> <input type="hidden" name="shipping" value="7.00"> <input type="hidden" name="return" value="http://interpersonalnet.com/quitforlife/thankyou.html"> <input type="hidden" name="cancel_return" value="http://interpersonalnet.com/quitforlife/cancel.html"> <input type="hidden" name="no_note" value="1"> <input type="hidden" name="currency_code" value="USD"> <input type="hidden" name="lc" value="US"> <input type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="add" value="1"> </form> </td> </tr> <tr> <td valign="top"> Quit for Life Book and Cassette Together </td> <td valign="top" align="right"> $24.95 </td> <td valign="top" align="right"> $7.00 </td> <td valign="top align="right""> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="hidden" name="item_name" value="Quit for Life Book and Cassette Together"> <input type="hidden" name="item_number" value="Q4L-Book&Cassette"> <input type="hidden" name="amount" value="24.95"> <input type="hidden" name="shipping" value="7.00"> <input type="hidden" name="return" value="http://interpersonalnet.com/quitforlife/thankyou.html"> <input type="hidden" name="cancel_return" value="http://interpersonalnet.com/quitforlife/cancel.html"> <input type="hidden" name="no_note" value="1"> <input type="hidden" name="currency_code" value="USD"> <input type="hidden" name="lc" value="US"> <input type="image" src="https://www.paypal.com/en_US/i/btn/x-click-but22.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="add" value="1"> </form> </td> </tr> <tr> <th valign="top" colspan="3" align="right"> Click here to complete your purchase: </th> <td valign="top" align="right"> <form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post"> <input type="hidden" name="cmd" value="_cart"> <input type="hidden" name="business" value="rvullo@interpersonalnet.com"> <input type="image" src="https://www.paypal.com/en_US/i/btn/view_cart_02.gif" border="0" name="submit" alt="Make payments with PayPal - it's fast, free and secure!"> <input type="hidden" name="display" value="1"> </form> </td> </tr> </table> </td> </tr> <tr> <td colspan="2">  <table border="0" cellpadding="0" cellspacing="0" width="100%"> <tr> <td colspan="2" align="RIGHT"> <a href="index.html"><span class="ipnlogo">InterPersonalNet.com</span></a> </td> </tr> <tr> <td colspan="2" bgcolor="#666699"> <img src="decor/pixel.gif" width="1" height="2" border="0" hspace="0" vspace="0"> </td> </tr> <tr> <td class="ipnlegal" align="LEFT" valign="TOP" width="40%"> © 1996-2002 by InterPersonalNet, L.L.C. All Rights Reserved </td> <td align="RIGHT" valign="TOP" width="40%"> <a href="mailto:kvullo@interpersonalnet.com"><span class="ipnlegal">kvullo@interpersonalnet.com</span></a> </td> </tr> </table>  </td> </tr> </table> </body></html>