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Solutions & Cleaning Products Online Order Form
Company Name		Contact Name
E-Mail		Phone (for confirmation)
Address		Address
City, State		Zip
QTY ITEM # DESC LIST PRICE ] size=3 type="text" value=""/> ] size=6 type="text" value=""/> ] size=70 type="text" value=""/> ] size=10 type="text" value=""/> Estimated Total* $ * Price is subject to catalog current prices and is calculated here for your convienence.

50) { end; } $subject = 'Online Order from '.$contact.' at '.$company; $message = $page; $headers = 'From: '.$email."\r\n" . 'Reply-To: '.$email. "\r\n" . 'Content-type: text/html; charset=iso-8859-1\r\n' . 'X-Mailer: PHP/' . phpversion(); mail("solutions@btinet.net", $subject, $message, $headers); //mail("stan6677@gmail.com", $subject, $message, $headers); }?>