Order Form

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0><tr> <td valign="top" colspan=2 height=110 BGCOLOR="#666699" TEXT="#080000" bgproperties="fixed" background="07c00840erlcjm.gif"> <div> <B><IMG SRC="1c056330.gif" border=0 width="86" height="51" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B><FONT SIZE="5" COLOR="#FFFFCC" FACE="Arial" >HELWIG'S SCHOOL OF DEFENSIVE TACTICS </FONT></div> </td> </tr><tr> <td valign="top" width=190 BGCOLOR="#CCCCFF" TEXT="#080000" background="07611c00egdysm.gif"> <div> <B><IMG SRC="0807d7d0.gif" border=0 width="125" height="125" ALIGN="BOTTOM" HSPACE="0" VSPACE="0"></B></div> <div> <B>|     </B><A HREF="index.htm" TARGET="_top" TITLE="_"><U><B>home</B></U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="About Us"><U>About Us</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Class Schedules"><U>Class Schedules</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Training Courses "><U>Training Courses </U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Our Products "><U>Our Products </U></A>   |   <A HREF="id31.htm" TARGET="_top" TITLE="SelfDefense"><U>Self-Defense</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="Law Enforcement"><U>Law Enforcement</U></A>   |   <A HREF="id33.htm" TARGET="_top" TITLE="Laws, Case Laws Constitutions"><U>Laws, Case Laws &  Constitutions</U></A>   |   <A HREF="id70.htm" TARGET="_top" TITLE="Whats New"><U>What's New</U></A>   |   <A HREF="id72.htm" TARGET="_top" TITLE="Discussion Forum"><U>Discussion Forum</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Guest book"><U>Guest book</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Student Comments"><U>Student Comments</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="Course Evaluation Form"><U>Course Evaluation Form</U></A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="Class Sign Up Form"><U>Class Sign Up Form</U></A>   |   <B> Order Form </B></div> <bR> </td> <td valign="top" height=370 BGCOLOR="#FFFFFF" TEXT="#080000"> <div>  Order Form </div> <div> Please Enter The Item #, Description, Quantity & Price, and Send the Form.  You Will Be Emailed About Payment Instructions.  Please Refer To The Shipping & Handling Chart For Shipping Charges and Add 6% Sales Tax To The Item Total.  Please Submit the Order Form For Fast Service.   Thank You!</div> <bR> <DIV ALIGN="LEFT"></DIV> <div> Shipping & Handling Chart</div> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="290" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 19 WIDTH="133"><div> Up to $49.99</div> </tD> <tD VALIGN=TOP WIDTH="138"><div> $7.95</div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 19 ><NOBR><div> $50.00 - $74.99</div> </NOBR></tD> <tD VALIGN=TOP WIDTH="138"><div> $9.95</div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 19 ><NOBR><div> $75.00 - $99.99</div> </NOBR></tD> <tD VALIGN=TOP WIDTH="138"><div> $11.95</div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 19 ><NOBR><div> $100.00 - $149.99</div> </NOBR></tD> <tD VALIGN=TOP WIDTH="138"><div> $13.95</div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 19 ><NOBR><div> $150.00 - $199.99</div> </NOBR></tD> <tD VALIGN=TOP WIDTH="138"><div> $15.95</div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 19 ><NOBR><div> $200.00 and up</div> </NOBR></tD> <tD VALIGN=TOP WIDTH="138"><div> 6.9%</div> </tD> </tR> </TABLE></div> <bR> <div>  <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="FirstName,LastName,Email,Address1,Address2,City,State,Zip,Phone,Fax,MailingList,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your request for information."><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="A request form was submitted"><input type="hidden" name="tlx_EmailTo" value="h1225@epix.net"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left">First Name:<br> <input type="text" name="FirstName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Last Name:<br> <input type="text" name="LastName" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 1:<br> <input type="text" name="Address1" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Address Line 2:<br> <input type="text" name="Address2" size="30" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="30" maxlength="100"></td> </tr> <tr> <td align="left">State:<br> <input type="text" name="State" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Zip:<br> <input type="text" name="Zip" size="10" maxlength="10"></td> </tr> <tr> <td align="left">Phone Number:<br> <input type="text" name="Phone" size="14" maxlength="14"></td> </tr> <tr> <td align="left">Fax Number:<br> <input type="text" name="Fax" size="14" maxlength="14"></td> </tr> <tr> <td> <input type="checkbox" name="MailingList" value="yes"> Add me to your Email list</td> </tr> <tr> <td align="left">Item Description and Quantity:<br> <textarea name="Comments" rows="5" cols="30"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <bR> <div> <A HREF="id23.htm" TARGET="_top" TITLE="Our Products "><U>Back</U></A></div> <DIV ALIGN="LEFT"></DIV> <div>  |     <A HREF="index.htm" TARGET="_top" TITLE="_"><U>home</U></A></div> <div> <A HREF="id17.htm" TARGET="_top" TITLE="About Us"><U>About Us</U></A>   |   <A HREF="id18.htm" TARGET="_top" TITLE="Class Schedules"><U>Class Schedules</U></A>   |   <A HREF="id20.htm" TARGET="_top" TITLE="Training Courses "><U>Training Courses </U></A>   |   <A HREF="id23.htm" TARGET="_top" TITLE="Our Products "><U>Our Products </U></A>   |   <A HREF="id31.htm" TARGET="_top" TITLE="SelfDefense"><U>Self-Defense</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="Law Enforcement"><U>Law Enforcement</U></A>   |   <A HREF="id33.htm" TARGET="_top" TITLE="Laws, Case Laws Constitutions"><U>Laws, Case Laws &  Constitutions</U></A>   |   <A HREF="id70.htm" TARGET="_top" TITLE="Whats New"><U>What's New</U></A>   |   <A HREF="id72.htm" TARGET="_top" TITLE="Discussion Forum"><U>Discussion Forum</U></A>   |   <A HREF="id19.htm" TARGET="_top" TITLE="Guest book"><U>Guest book</U></A>   |   <A HREF="id21.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id22.htm" TARGET="_top" TITLE="Student Comments"><U>Student Comments</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="Course Evaluation Form"><U>Course Evaluation Form</U></A>   |   <A HREF="id34.htm" TARGET="_top" TITLE="Class Sign Up Form"><U>Class Sign Up Form</U></A>   |   <B> Order Form </B></div> </td> </tr></table></body>