Online Order Form1


Problem encountered...

You forgot to enter your email address, your name, or your credit card number. Please use the back button and resubmit your request. If you feel you are getting this message in error, please email us"; $valid="notOK"; } /* if the above are ok, send the order to Betty */ if (!$custemail == "" && $valid == "OK") { mail ("dave@wave-creative.com,betty@betty-johnson.com", "CD Order", "Name: $firstname $lastname\nAddress: $address\nCity: $city\nState: $state\nZip: $zip\nCountry: $country\nPhone: $phone\nFax: $fax\nEmail address: $custemail\n \nShipping Address (only if different, so may be blank): $shippingaddress\nCity: $shippingcity\nState: $shippingstate\nZip: $shippingzip\nCountry: $shippingcountry\n Name on Credit Card: $ccname\nCredit Card Number: $ccnumber\nExpiration Date: $expdate\n Order Total: $theTotal\n\n ---------------------------------\n Items Ordered (shipping=flat rate of \$1.50 per order)\n\n CD Singing on the Mountain \$15 : $singingCD\nCD In Her Own Words \$34.95 : $InHerWordsCD\nCD In My Eyes \$15 : $InMyEyesCD\nCD Chattanooga Swing \$15 : $chattanoogaCD\nCD Greatest Hits Volume 2 \$15 : $ghvol2CD\nCD Greatest Hits Volume 1 \$15 : $ghvol1CD\nCD Love Walked In \$15 : $lovewalkedinCD\nCassette Love Walked In \$10 : $lovewalkedinCassette\nCD Take Five Sessions \$15 : $takeFiveCD\nCassette Take Five Sessions \$10 : $takeFiveCassette\nCD A Family Affair \$15 : $familyAffairCD\nCassette A Family Affair \$10 : $familyAffairCassette\nCD In The Garden \$15 : $inTheGardenCD\nCassette In The Garden \$10 : $inTheGardenCassette\nCD My Heart Sings \$15 : $myHeartSingsCD\nCassette My Heart Sings \$10 : $myHeartSingsCassette\nCD Soft Lights, Sweet Music \$15 : $softSweetCD\nCD We Sang for Our Supper \$15 : $supperCD\nCD Sunday Mornings in Dixie \$15 : $dixieCD\nCD Brazillian Breezes \$15 : $brazilCD\nCD Make Yourself Comfortable \$15 : $comfortCD\nCD Take Me Along \$15 : $takemealongCD\n", "Reply-To: $custemail\nFrom: $custemail\nSender: $custemail"); mail ("$custemail", "CD Order confirmation", "This is your order confirmation from Betty-Johnson.com, please save it for your records.\n\nName: $firstname $lastname\nAddress: $address\nCity: $city\nState: $state\nZip: $zip\nCountry: $country\nPhone: $phone\nFax: $fax\nEmail address: $custemail\n \nShipping Address: $shippingaddress\nCity: $shippingcity\nState: $shippingstate\nZip: $shippingzip\nCountry: $shippingcountry\n Name on Credit Card: $ccname\n Order Total: $theTotal\n\n ---------------------------------\n Items Ordered (shipping=flat rate of \$1.50 per order)\n\n CD Singing on the Mountain \$15 : $singingCD\nCD In Her Own Words \$35 : $InHerWordsCD\nCD In My Eyes \$15 : $InMyEyesCD\nCD Chattanooga Swing \$15 : $chattanoogaCD\nCD Greatest Hits Volume 2 \$15 : $ghvol2CD\nCD Greatest Hits Volume 1 \$15 : $ghvol1CD\nCD Love Walked In \$15 : $lovewalkedinCD\nCassette Love Walked In \$10 : $lovewalkedinCassette\nCD Take Five Sessions \$15 : $takeFiveCD\nCassette Take Five Sessions \$10 : $takeFiveCassette\nCD A Family Affair \$15 : $familyAffairCD\nCassette A Family Affair \$10 : $familyAffairCassette\nCD In The Garden \$15 : $inTheGardenCD\nCassette In The Garden \$10 : $inTheGardenCassette\nCD My Heart Sings \$15 : $myHeartSingsCD\nCassette My Heart Sings \$10 : $myHeartSingsCassette\nCD Soft Lights, Sweet Music \$15 : $softSweetCD\nCD We Sang for Our Supper \$15 : $supperCD\nCD Sunday Mornings in Dixie \$15 : $dixieCD\nCD Brazillian Breezes \$15 : $brazilCD\nCD Make Yourself Comfortable \$15 : $comfortCD\nCD Take Me Along \$15 : $takemealongCD\n", "Reply-To: betty@betty-johnson.com\nFrom: betty@betty-johnson.com\nSender: betty@betty-johnson.com"); /* end mailing code, begin file writing code */ $filename="order.log.html"; $fp = fopen($filename,"a+"); if( $fp == -1 ) { Exit; } else { fputs( $fp, "\"$firstname\",\"$lastname\",\"$address\",\"$city\",\"$state\",\"$zip\",\"$country\",\"$shippingaddress\",\"$shippingcity\",\"$shippingstate\",\"$shippingzip\",\"$shippingcountry\",\"$phone\",\"$fax\",\"$custemail\",\"$comments\", \"$ccname\", \"$theTotal\",\"$singingCD\",\"$InHerWordsCD\",\"$InMyEyesCD\",\"$chattanoogaCD\",\"$chattanoogaCassette\",\"$ghvol2CD\",\"$ghvol2Cassette\",\"$ghvol1CD\",\"$ghvol1Cassette\",\"$lovewalkedinCD\",\"$lovewalkedinCassette\",\"$takeFiveCD\",\"$takeFiveCassette\",\"$familyAffairCD\",\"$familyAffairCassette\",\"$inTheGardenCD\",\"$inTheGardenCassette\",\"$myHeartSingsCD\",\"$myHeartSingsCassette\",\"$softSweetCD\",\"$softSweetCassette\",\"$supperCD\",\"$supperCassette\", \"$dixieCD\",\"$brazilCD\",\"$comfortCD\",\"$takemealongCD\",
"); fclose($fp); } $message="

Thanks for your order!

Thanks, we sincerely appreciate your order, and it will be shipped right out. Please be sure to visit our guestbook and leave a comment or two.

The total to be charged to your card is \$ $theTotal




"; /* end global if statement-error checking routine */ } /* find the correct thanks page headers and footers */ echo "$message \n"; include ("betty.orderform.pagebottom.html"); } else { ?>
First Name:
Last Name:
Billing Address:
City:
State/Province:

Country:
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Phone:
Fax:
E-mail address:

Your Privacy Matters to Us
We will only use your phone number if there is a question about the order.
We will not share or sell your information with any other company.

Credit Card Information (Visa & MasterCard only):

Name (as appears on card): 

Card #: 

Exp. date: (MM/YY)


Only use this section if different from billing address
Shipping Address:
City:
State/Province:

Country:
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Quantity

Format

Title

Price

Total

CD Singing on the Mountain $15
8 CDs Betty Johnson - In Her Own Words $34.95
CD In My Eyes (Lydia Gray) $15
CD Chattanooga Swing $15
CD Greatest Hits Volume 2 $15
CD Greatest Hits Volume 1 $15
CD Love Walked In $15
Cassette Love Walked In $10
CD Take Five Sessions $15
Cassette Take Five Sessions $10
CD A Family Affair $15
Cassette A Family Affair $10
CD In The Garden $15
Cassette In The Garden $10
CD My Heart Sings $15
Cassette My Heart Sings $10
CD Soft Lights, Sweet Music $15
CD We Sang for Our Supper $15
CD Sunday Mornings in Dixie $15
CD Brazilian Breezes ...Mostly Jobim (Lydia Gray) $15
CD Make Yourself Comfortable $15
CD Take Me Along $15

 

Shipping is a flat $1.50 per order. For a limited time there is free shipping for "In Her Own Words." Shipping charges will be deducted when your card is charged.  

TOTAL:

Recalculate order subtotal $  


To order by phone, call toll free:  1-800-838-6110

or by mail:

Press the Print button on your web browser and mail this form along with payment to:
Bliss Tavern Music, Haverhill, New Hampshire, 03765