tag:blogger.com,1999:blog-32164313856099595252011-04-21T13:13:53.483-07:00COLORFULIFE!http://www.blogger.com/profile/01538630783658015100noreply@blogger.comBlogger11100tag:blogger.com,1999:blog-3216431385609959525.post-28599003300026445042008-09-19T01:12:00.001-07:002008-09-19T01:12:34.079-07:00<!-- Begin Freedback Form --><br /><!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT FREEDBACK.COM --><br /><form enctype="multipart/form-data" method="post" action="http://www.freedback.com/mail.php" charset="UTF-8"><br /> <div><br /> <input name="acctid" id="acctid" value="0zqo4gq1zrzlc4g5" type="hidden"><br /> <input name="formid" id="formid" value="475003" type="hidden"><br /> <input name="required_vars" id="required_vars" value="name,field-7d687a633a7fe93,field-a68661622914dee,email,field-d194c2960ed6bcb,field-ddae66b820886c3,field-64fc627573d44bf" type="hidden"><br /> </div><br /> <table border="0" cellpadding="5" cellspacing="5"><br /> <tbody><tr><br /> <td valign="top"><br /> <strong>Name:</strong><br /> </td><br /> <td valign="top"><br /> <input name="name" id="name" size="40" value="" type="text"><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>Address:</strong><br /> </td><br /> <td valign="top"><br /> <input name="field-7d687a633a7fe93" id="field-7d687a633a7fe93" size="40" value="" type="text"><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>Contact Number:</strong><br /> </td><br /> <td valign="top"><br /> <input name="field-a68661622914dee" id="field-a68661622914dee" size="40" value="" type="text"><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>Email Address:</strong><br /> </td><br /> <td valign="top"><br /> <input name="email" id="email" size="40" value="" type="text"><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>List of items:<br /> (Please enter the product code)</strong><br /> </td><br /> <td valign="top"><br /> <textarea name="field-d194c2960ed6bcb" id="field-d194c2960ed6bcb" rows="6" cols="40"></textarea><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>Delivery Mode:</strong><br /> </td><br /> <td valign="top"><br /> <input name="field-ddae66b820886c3" id="field-ddae66b820886c3_0" value="Meet up at selected MRT Stations." type="radio"> Meet up at selected MRT Stations.<br /><br /> <input name="field-ddae66b820886c3" id="field-ddae66b820886c3_1" value="Collect at any UncleTidbits Branches." type="radio"> Collect at any UncleTidbits Branches.<br /><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td valign="top"><br /> <strong>Payment By:</strong><br /> </td><br /> <td valign="top"><br /> <input name="field-64fc627573d44bf" id="field-64fc627573d44bf_0" value="Cash" type="radio"> Cash<br /><br /> <input name="field-64fc627573d44bf" id="field-64fc627573d44bf_1" value="DBS/POSB ATM Transfer" type="radio"> DBS/POSB ATM Transfer<br /><br /> <input name="field-64fc627573d44bf" id="field-64fc627573d44bf_2" value="DBS/POSB I-Banking Transfer" type="radio"> DBS/POSB I-Banking Transfer<br /><br /> <br /> </td><br /> </tr><br /> <tr><br /> <td colspan="2" align="center"><br /> <input value=" Submit Form " type="submit"><br /> </td><br /> </tr><br /> </tbody></table><br /></form><br /><br /><!-- End Freedback Form --><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/3216431385609959525-2859900330002644504?l=colorfulife-bshop-orders.blogspot.com' alt='' /></div>COLORFULIFE!http://www.blogger.com/profile/01538630783658015100noreply@blogger.com0