Request Literature

<body topmargin=0 leftmargin=0 marginheight=0 marginwidth=0> <table cellpadding=0 cellspacing=0 border=0 height="100%"><tr> <td valign="top" width=195 style="border-right: 5px solid #000000;" BGCOLOR="#6699CC" TEXT="#080000"> <bR> <div> <TABLE BORDER="10" CELLPADDING="1" CELLSPACING="0" WIDTH="150" BORDERCOLORLIGHT="#6699CC" BORDERCOLORDARK="#6699CC" FRAME="VOID" RULES="ALL" HSPACE="0" VSPACE="0" BGCOLOR=#FFFFFF > <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="index.htm" TARGET="_top" TITLE="The Old Muffin Factory"><B>home</B></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="id17.htm" TARGET="_top" TITLE="About Us"><B>about us</B></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 ><NOBR><div> <A HREF="id20.htm" TARGET="_top" TITLE="Our Products"><B>our products</B></A></div> </NOBR></tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="gift_boxes.htm" TARGET="_top" TITLE="Gift Boxes"><B>gift boxes</B></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="id19.htm" TARGET="_top" TITLE="Contact Us"><B>contact us</B></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="wholesalelogin.htm" TARGET="_top" TITLE="Wholesale"><B>wholesale</B></A></div> </tD> </tR> <tR> <tD VALIGN=TOP HEIGHT= 30 WIDTH="148"><div> <A HREF="fundraising.htm" TARGET="_top" TITLE="Fundraising"><B>fundraising</B></A></div> </tD> </tR> </TABLE></div> <bR> </td> <td valign="top" width="100%" BGCOLOR="#FFFFFF" TEXT="#080000"> <bR> <div> Request Literature</div> <div> Use this form to submit your wholesale catalog request via email, or regular mail. We will send you a full color catalog containing photos, descriptions and prices of the various baking mixes we manufacture. To download a .pdf version of the catalog <FONT SIZE="2" COLOR="#FF0000" FACE="Arial" ><B>click here</B></FONT>. Please remember, only those stores who provide us with a valid State sales tax ID number, and a confirmed address for their place of business will be eligible for wholesale pricing.</div> <bR> <DIV ALIGN="LEFT"></DIV> <div>    <form enctype="multipart/form-data" method="post" action="http://www.response-o-matic.com/mail.php" accept-charset="UTF-8"> <div> <input type="hidden" name="acctid" id="acctid" value="go0ptn934q2zogjs" /> <input type="hidden" name="formid" id="formid" value="578208" /> <input type="hidden" name="required_vars" id="required_vars" value="name,email,field-20c13738ea37f1d,field-fc00b798745426d,field-964c76bf1f3fa75,field-76ba0628544832c,field-df91141b98aaf7d" /> </div> <table cellspacing="5" cellpadding="5" border="0"> <tr> <td valign="top"> <strong>Store Name:</strong> </td> <td valign="top"> <input type="text" name="name" id="name" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Email Address:</strong> </td> <td valign="top"> <input type="text" name="email" id="email" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>State sales tax registration number:</strong> </td> <td valign="top"> <input type="text" name="field-20c13738ea37f1d" id="field-20c13738ea37f1d" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Buyer's Name:</strong> </td> <td valign="top"> <input type="text" name="field-fc00b798745426d" id="field-fc00b798745426d" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Mailing address:</strong> </td> <td valign="top"> <input type="text" name="field-964c76bf1f3fa75" id="field-964c76bf1f3fa75" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>City, ST Zip:</strong> </td> <td valign="top"> <input type="text" name="field-76ba0628544832c" id="field-76ba0628544832c" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Catalog options:</strong> </td> <td valign="top"> <select name="field-df91141b98aaf7d" id="field-df91141b98aaf7d"> <option value="Full color catalog via US Mail">Full color catalog via US Mail</option> <option value="Full color catalog via email">Full color catalog via email</option> <option value="Gray scale catalog via fax">Gray scale catalog via fax</option> </select> </td> </tr> <tr> <td valign="top"> <strong>Phone number:</strong> </td> <td valign="top"> <input type="text" name="field-44bf6bad064ffe5" id="field-44bf6bad064ffe5" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Fax number:</strong> </td> <td valign="top"> <input type="text" name="field-69de87612477d86" id="field-69de87612477d86" size="40" value="" /> </td> </tr> <tr> <td valign="top"> <strong>Comments:</strong> </td> <td valign="top"> <textarea name="field-328e530eb856443" id="field-328e530eb856443" rows="6" cols="40"></textarea> </td> </tr> <tr> <td colspan="2" align="center"> <input type="submit" value=" Submit Form " /> </td> </tr> </table> </form> <br><center><font face="Arial, Helvetica" size="1"><b> <a href="http://www.response-o-matic.com">form mail</a> </b></font></center>   </div> </td> </tr></table></body>