MIME-Version: 1.0 Server: CERN/3.0 Date: Monday, 06-Jan-97 22:44:46 GMT Content-Type: text/html Content-Length: 1953 Last-Modified: Monday, 28-Aug-95 20:56:14 GMT This is a practice form.

Welcome to the Order List


Please give me the answers to the following questions:

Your name?

Your address?

What do you want to order?

  1. Pizza
  2. Burger
  3. Fried Chicken
  4. Big Mac
  5. Others
Any drinks?

Other things?

How would you like to pay? Choose any one of the following:

  1. Cash.
  2. Check.
  3. Credit card:
    • Mastercard.
    • Visa.
    • American Express.

Thanks for your order. Any comments?