Demo Order From

Demo Order Form
This is a fictitious Order Form for learning purposes only
You are not ordering anything using this Form

Please type the quantity in the Quantity column of the product(s) you wish to order
Product		Price per pound	Quantity in Pounds
	Broccoli	$2.50
	Pickles	$1.75
	Pepper	$2.25
	Tomato	$3.10
	Pumpkin	$2.80
	Garlic	$1.95
	Banana	$2.25

Please type your credit card information:

American Express MasterCard Visa

Credit Card Number:

1234-5678-9012-3456

Expiration (MM/YYYY):

10/2004

Please type the following information:

First Name:

Last Name:

Be accurate when typing your Email, this sample sends you an Email with your password (so that you will be able to follow up on your orders).

Email: