ORDER FORM

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=200 BGCOLOR="#003333" TEXT="#F7F7FF" background="3e7d4c00dduajq.gif"> <div> <TABLE BORDER="0" CELLPADDING="2" CELLSPACING="0" WIDTH="95" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 46 WIDTH="91"><IMG BORDER="0" SRC="1x1.gif" HEIGHT="46" ALIGN="bottom" WIDTH="91" HSPACE="0" VSPACE="0"></tD> </tR> </TABLE></div> <bR> <div> <A HREF="http://members.tripod.com/cozads" TARGET="_top" TITLE="http://members.tripod.com/cozads"><U>Back to Cozads Ornaments</U></A></div> <bR> <div> <A HREF="index.htm" TARGET="_top" TITLE="Cozads Wood Toys "><U>Back to Cozads Wood Toys</U></A></div> <bR> <div> NOTE on using this form</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Please check all information for accuracy</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Proper shipping charge</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Double check addition</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">If you have questions or need help in filling in the proper amounts e-mail  <A HREF="mailto:games@cozads.com" TARGET="_top" TITLE="mailto:games@cozads.com"><U>games@cozads.com  </U></A>for assistance</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c8ffffff00.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">All information must be accurate before your order  will  ship</div> <DIV ALIGN="LEFT"></DIV> <div> SHIPPING</div> <div> <TABLE BORDER="2" CELLPADDING="2" CELLSPACING="1" WIDTH="164" BORDERCOLORLIGHT="#C0C0C0" BORDERCOLORDARK="#808080" FRAME="BOX" RULES="ALL" ALIGN="BOTTOM" HSPACE="0" VSPACE="0" > <tR> <tD VALIGN=TOP HEIGHT= 16 ><NOBR><div> $     .01 - $ 19.99</div> </NOBR></tD> <tD VALIGN=TOP><NOBR><div> $ 10.00</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 16 ><NOBR><div> $ 20.00 - $ 34.99</div> </NOBR></tD> <tD VALIGN=TOP><NOBR><div> $ 15.00</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 16 ><NOBR><div> $ 35.00 - $ 44.99</div> </NOBR></tD> <tD VALIGN=TOP><NOBR><div> $ 20.00</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 16 ><NOBR><div> $ 45.00 - $ 89.99</div> </NOBR></tD> <tD VALIGN=TOP><NOBR><div> $ 25.00</div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 16 WIDTH="96"><div> $ 90.00  +</div> </tD> <tD VALIGN=TOP><NOBR><div> $ 30.00</div> </NOBR></tD> </tR> </TABLE></div> <bR> </td> <td valign="top" BGCOLOR="#FFFFFF" TEXT="#080000"> <div> <FONT SIZE="5" COLOR="#003333" FACE="Arial" ><B>Cozads Wood Toys </B></FONT>     |     <A HREF="index.htm" TARGET="_top" TITLE="Cozads Wood Toys "><U>home</U></A></div> <div> <A HREF="id24.htm" TARGET="_top" TITLE="LINKS page"><U>LINKS page</U></A>   |   <A HREF="id25.htm" TARGET="_top" TITLE="washerboard"><U>washerboard</U></A>   |   <A HREF="id44.htm" TARGET="_top" TITLE="Bola photos"><U>Bola photos</U></A>   |   <A HREF="id45.htm" TARGET="_top" TITLE="BOLA RULES"><U>BOLA RULES</U></A>   |   <A HREF="id43.htm" TARGET="_top" TITLE="Bola comments"><U>Bola comments</U></A>   |   <A HREF="id26.htm" TARGET="_top" TITLE="Bola ( polish golf )"><U>Bola ( polish golf )</U></A>   |   <A HREF="id27.htm" TARGET="_top" TITLE="score card"><U>score card</U></A>   |   <A HREF="id28.htm" TARGET="_top" TITLE="marshmallow blowgun"><U>marshmallow blowgun</U></A>   |   <A HREF="id42.htm" TARGET="_top" TITLE="Shut box Rules"><U>Shut box Rules</U></A>   |   <A HREF="id41.htm" TARGET="_top" TITLE="Shut box History"><U>Shut box History</U></A>   |   <A HREF="dice_game.htm" TARGET="_top" TITLE="shut box dice game"><U>shut box dice game</U></A>   |   <A HREF="id32.htm" TARGET="_top" TITLE="birdhouse"><U>birdhouse</U></A>   |   <A HREF="id6.htm" TARGET="_top" TITLE="Contact Us"><U>Contact Us</U></A>   |   <A HREF="id35.htm" TARGET="_top" TITLE="Barbie"><U>Barbie</U></A>   |   <B>ORDER FORM</B>   |   <A HREF="id37.htm" TARGET="_top" TITLE="Welchs"><U>Welch's</U></A>   |   <A HREF="id38.htm" TARGET="_top" TITLE="Die Cast Trucks"><U>Die Cast Trucks</U></A>   |   <A HREF="id39.htm" TARGET="_top" TITLE="Customer service"><U>Customer service</U></A></div> <div> ORDER FORM</div> <DIV ALIGN="LEFT"></DIV> <div> <B>Do not use this page if ordering by shopping cart or PayPal</B></div> <div> <B>Note the left column for important ordering information and shipping charges. </B></div> <div> If you prefer to order the old fashion way</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c800000000.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Please fill out all necessary information</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c800000000.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Print this form</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c800000000.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Include check or money order for Total amount, </div> <div>                      payable to: <B> </B><B>Ed Cozad</B>     </div> <DIV ALIGN="LEFT"></DIV> <div>                 Checks and money orders are only accepted when made  payable to Ed Cozad:<B> DO</B> <B>NOT</B> use any other title. Thank you</div> <div> <IMG BORDER="0" SRC="Symb075c00b700c800000000.gif" HEIGHT="13" WIDTH="24" ALIGN="bottom" HSPACE="0" VSPACE="0">Mail to:   Ed Cozad</div> <div>                        2778 N.E. 24 th Ave</div> <div>                        Owatonna, Mn  55060</div> <DIV ALIGN="LEFT"></DIV> <div>  <form action="http://formmail.trellix.com/servlets/TlxMailer" method="POST" enctype="application/x-www-form-urlencoded"><input type="hidden" name="tlx_SortOrder" value="Name,Address,City,State and Zip Code,Email,QTY---DESCRIPTION [A],PRICE: $,QTY---DESCRIPTION [B],PRICE: $ ,TOTAL of above items $ .,Shipping,TOTAL,Comments"><input type="hidden" name="tlx_FormIndex" value="2"><input type="hidden" name="tlx_OKMessage" value="Thank you for your order. Your product will be shipped upon receipt of payment. Or in some cases, when check clears"><input type="hidden" name="tlx_SendMode" value="1"><input type="hidden" name="tlx_Subject" value="An ORDER form was submitted"><input type="hidden" name="tlx_EmailTo" value="cozads@myclearwave.net"> <table cellpadding="0" cellspacing="1" border="0" align="center"> <tr> <td align="left"> Name:<br> <input type="text" name="Name" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Address :<br> <input type="text" name="Address" size="50" maxlength="100"></td> </tr> <tr> <td align="left">City:<br> <input type="text" name="City" size="50" maxlength="100"></td> </tr> <tr> <td align="left">State and Zip Code:<br> <input type="text" name="State and Zip Code" size="50" maxlength="100"></td> </tr> <tr> <td align="left">Email:<br> <input type="text" name="Email" size="50" maxlength="100"></td> </tr> <tr> <td align="left">QTY---DESCRIPTION [A]:<br> <input type="text" name="QTY---DESCRIPTION [A]" size="50" maxlength="100"></td> </tr> <tr> <td align="left">PRICE: $ :<br> <input type="text" name="PRICE: $" size="10" maxlength="100"></td> </tr> <tr> <td align="left">QTY---DESCRIPTION [B]:<br> <input type="text" name="QTY---DESCRIPTION [B]" size="50" maxlength="100"></td> </tr> <tr> <td align="left">PRICE: $ :<br> <input type="text" name="PRICE: $ " size="10" maxlength="100"></td> </tr> <tr> <td align="left">TOTAL of above items $ .:<br> <input type="text" name="TOTAL of above items $ ." size="10" maxlength="100"></td> </tr> <tr> <td align="left">enter shipping charge from chart:<br> <input type="text" name="Shipping" size="10" maxlength="10"></td> </tr> <tr> <td align="left">TOTAL:<br> <input type="text" name="TOTAL" size="30" maxlength="100"></td> </tr> <tr> <td align="left">Comments:<br> <textarea name="Comments" rows="5" cols="50"></textarea></td> </tr> <tr> <td align="right"><input type="reset"> <input type="submit" value="Send" name="tlx_send"></td> </tr> </table> </form>  </div> <div> After filling out the above form. Print this page using your browsers print button and then hit the send button. This will allow me extra time to prepare your order for shipment upon receipt of payment. Please include the printed copy with your payment.</div> <div> Thank you</div> <bR> <bR> <bR> </td> </tr></table></body>