<!-- Begin Response-O-Matic Form -->
<!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT RESPONSE-O-MATIC.COM -->
<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="3toi9cn1iegg8s3c" />
<input type="hidden" name="formid" id="formid" value="1218586" />
<input type="hidden" name="required_vars" id="required_vars" value="name,field-42fcacc421bbc90,field-759ab6f1a02985d,field-af7ba61bf6bfe25,field-2897f4ea985106a,field-a84f8580f921f46,field-bcd6993ff12d799,field-098dd66036c4ebd,field-6b21aa6c4792459,field-6559e188b1c67c1,field-4d8fc7b5febe290,field-134fd1589bac453,field-c766c264a54482e,field-48cf0a11ec4d733,field-cab434fa9a77f82,email" />
</div>
<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>Tarikh Tempahan</strong>
</td>
<td valign="top">
<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Alamat Email </strong>
</td>
<td valign="top">
<input type="text" name="field-42fcacc421bbc90" id="field-42fcacc421bbc90" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Tempahan Untuk</strong>
</td>
<td valign="top">
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_0" value="Kad Kahwin" /> Kad Kahwin<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_1" value="Banner/Banting" /> Banner/Banting<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_2" value="Stiker Bulat" /> Stiker Bulat<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_3" value="Baju Printing" /> Baju Printing<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_4" value="Kotak Cenderahati" /> Kotak Cenderahati<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_5" value="Tq Tag" /> Tq Tag<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>Jenis Tempahan</strong>
</td>
<td valign="top">
<select name="field-af7ba61bf6bfe25" id="field-af7ba61bf6bfe25">
<option value="Biasa">Biasa</option>
<option value="18 Hari Urgent Cas RM100">18 Hari Urgent Cas RM100</option>
<option value="20 Hari Urgent Cas RM50">20 Hari Urgent Cas RM50</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Tempahan Bagi</strong>
</td>
<td valign="top">
<input type="radio" name="field-2897f4ea985106a" id="field-2897f4ea985106a_0" value="Kad Majlis 1 Pihak" /> Kad Majlis 1 Pihak<br/>
<input type="radio" name="field-2897f4ea985106a" id="field-2897f4ea985106a_1" value="Kad Majlis 2 Pihak" /> Kad Majlis 2 Pihak<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>Pakej Kad</strong>
</td>
<td valign="top">
<select name="field-a84f8580f921f46" id="field-a84f8580f921f46">
<option value="Sri Qaseh Single size 4x6">Sri Qaseh Single size 4x6</option>
<option value="Sri Qaseh 2 Fold size 4x6">Sri Qaseh 2 Fold size 4x6</option>
<option value="Sri Asmara Single size 4x8">Sri Asmara Single size 4x8</option>
<option value="Sri Asmara 2 Fold size 4x8">Sri Asmara 2 Fold size 4x8</option>
<option value="Sri Cinta Single Size 6x6">Sri Cinta Single Size 6x6</option>
<option value="Sri Cinta 2 Fold size 6x6">Sri Cinta 2 Fold size 6x6</option>
<option value="Sri Delima 3 Fold size 4x8">Sri Delima 3 Fold size 4x8</option>
<option value="2 Fold card one color size 4x8">2 Fold card one color size 4x8</option>
<option value="Hot Stamping">Hot Stamping</option>
<option value="Hard Cover">Hard Cover</option>
<option value="Craft card">Craft card</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Kuantiti kad</strong>
</td>
<td valign="top">
<select name="field-bcd6993ff12d799" id="field-bcd6993ff12d799">
<option value="500">500</option>
<option value="1000">1000</option>
<option value="1500">1500</option>
<option value="2000">2000</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Kod Design </strong>
</td>
<td valign="top">
<input type="text" name="field-098dd66036c4ebd" id="field-098dd66036c4ebd" size="40" value="" />
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p><strong>Maklumat Pengantin Lelaki</strong></p></strong>
</td>
</tr><tr>
<td valign="top">
<strong>Tarikh Majlis Lelaki: (Tarikh, Hari)</strong>
</td>
<td valign="top">
<input type="text" name="field-6b21aa6c4792459" id="field-6b21aa6c4792459" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Penuh Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-6559e188b1c67c1" id="field-6559e188b1c67c1" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Samaran/Nama pendek pada kad:</strong>
</td>
<td valign="top">
<input type="text" name="field-4d8fc7b5febe290" id="field-4d8fc7b5febe290" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Bapa Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-134fd1589bac453" id="field-134fd1589bac453" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Ibu Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-c766c264a54482e" id="field-c766c264a54482e" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Aturcara Majlis Lelaki: (cth:12.00pm-6.00pm)</strong>
</td>
<td valign="top">
<input type="text" name="field-604a1910e9151eb" id="field-604a1910e9151eb" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Ketibaan Pengantin/Waktu Bersanding:</strong>
</td>
<td valign="top">
<input type="text" name="field-a04e3065a0e2736" id="field-a04e3065a0e2736" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Turut Mengundang:
Seisi Keluarga</strong>
</td>
<td valign="top">
<input type="text" name="field-1f2807f49b5de12" id="field-1f2807f49b5de12" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Alamat Majlis:</strong>
</td>
<td valign="top">
<textarea name="field-48cf0a11ec4d733" id="field-48cf0a11ec4d733" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td valign="top">
<strong>Hubungi: (cth, ahli keluarga pengantin)</strong>
</td>
<td valign="top">
<textarea name="field-cab434fa9a77f82" id="field-cab434fa9a77f82" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p><strong>Maklumat Pengantin Perempuan</strong></p></strong>
</td>
</tr><tr>
<td colspan="2" valign="top">
<strong></strong>
</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 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">Click here</a> to put a form like this on your site.
</b></font></center>
<!-- End Response-O-Matic Form -->
<!-- DO NOT EDIT YOUR FORM HERE, PLEASE LOG IN AND EDIT AT RESPONSE-O-MATIC.COM -->
<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="3toi9cn1iegg8s3c" />
<input type="hidden" name="formid" id="formid" value="1218586" />
<input type="hidden" name="required_vars" id="required_vars" value="name,field-42fcacc421bbc90,field-759ab6f1a02985d,field-af7ba61bf6bfe25,field-2897f4ea985106a,field-a84f8580f921f46,field-bcd6993ff12d799,field-098dd66036c4ebd,field-6b21aa6c4792459,field-6559e188b1c67c1,field-4d8fc7b5febe290,field-134fd1589bac453,field-c766c264a54482e,field-48cf0a11ec4d733,field-cab434fa9a77f82,email" />
</div>
<table cellspacing="5" cellpadding="5" border="0">
<tr>
<td valign="top">
<strong>Tarikh Tempahan</strong>
</td>
<td valign="top">
<input type="text" name="name" id="name" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Alamat Email </strong>
</td>
<td valign="top">
<input type="text" name="field-42fcacc421bbc90" id="field-42fcacc421bbc90" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Tempahan Untuk</strong>
</td>
<td valign="top">
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_0" value="Kad Kahwin" /> Kad Kahwin<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_1" value="Banner/Banting" /> Banner/Banting<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_2" value="Stiker Bulat" /> Stiker Bulat<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_3" value="Baju Printing" /> Baju Printing<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_4" value="Kotak Cenderahati" /> Kotak Cenderahati<br/>
<input type="radio" name="field-759ab6f1a02985d" id="field-759ab6f1a02985d_5" value="Tq Tag" /> Tq Tag<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>Jenis Tempahan</strong>
</td>
<td valign="top">
<select name="field-af7ba61bf6bfe25" id="field-af7ba61bf6bfe25">
<option value="Biasa">Biasa</option>
<option value="18 Hari Urgent Cas RM100">18 Hari Urgent Cas RM100</option>
<option value="20 Hari Urgent Cas RM50">20 Hari Urgent Cas RM50</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Tempahan Bagi</strong>
</td>
<td valign="top">
<input type="radio" name="field-2897f4ea985106a" id="field-2897f4ea985106a_0" value="Kad Majlis 1 Pihak" /> Kad Majlis 1 Pihak<br/>
<input type="radio" name="field-2897f4ea985106a" id="field-2897f4ea985106a_1" value="Kad Majlis 2 Pihak" /> Kad Majlis 2 Pihak<br/>
</td>
</tr>
<tr>
<td valign="top">
<strong>Pakej Kad</strong>
</td>
<td valign="top">
<select name="field-a84f8580f921f46" id="field-a84f8580f921f46">
<option value="Sri Qaseh Single size 4x6">Sri Qaseh Single size 4x6</option>
<option value="Sri Qaseh 2 Fold size 4x6">Sri Qaseh 2 Fold size 4x6</option>
<option value="Sri Asmara Single size 4x8">Sri Asmara Single size 4x8</option>
<option value="Sri Asmara 2 Fold size 4x8">Sri Asmara 2 Fold size 4x8</option>
<option value="Sri Cinta Single Size 6x6">Sri Cinta Single Size 6x6</option>
<option value="Sri Cinta 2 Fold size 6x6">Sri Cinta 2 Fold size 6x6</option>
<option value="Sri Delima 3 Fold size 4x8">Sri Delima 3 Fold size 4x8</option>
<option value="2 Fold card one color size 4x8">2 Fold card one color size 4x8</option>
<option value="Hot Stamping">Hot Stamping</option>
<option value="Hard Cover">Hard Cover</option>
<option value="Craft card">Craft card</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Kuantiti kad</strong>
</td>
<td valign="top">
<select name="field-bcd6993ff12d799" id="field-bcd6993ff12d799">
<option value="500">500</option>
<option value="1000">1000</option>
<option value="1500">1500</option>
<option value="2000">2000</option>
</select>
</td>
</tr>
<tr>
<td valign="top">
<strong>Kod Design </strong>
</td>
<td valign="top">
<input type="text" name="field-098dd66036c4ebd" id="field-098dd66036c4ebd" size="40" value="" />
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p><strong>Maklumat Pengantin Lelaki</strong></p></strong>
</td>
</tr><tr>
<td valign="top">
<strong>Tarikh Majlis Lelaki: (Tarikh, Hari)</strong>
</td>
<td valign="top">
<input type="text" name="field-6b21aa6c4792459" id="field-6b21aa6c4792459" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Penuh Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-6559e188b1c67c1" id="field-6559e188b1c67c1" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Samaran/Nama pendek pada kad:</strong>
</td>
<td valign="top">
<input type="text" name="field-4d8fc7b5febe290" id="field-4d8fc7b5febe290" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Bapa Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-134fd1589bac453" id="field-134fd1589bac453" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Nama Ibu Pengantin Lelaki:</strong>
</td>
<td valign="top">
<input type="text" name="field-c766c264a54482e" id="field-c766c264a54482e" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Aturcara Majlis Lelaki: (cth:12.00pm-6.00pm)</strong>
</td>
<td valign="top">
<input type="text" name="field-604a1910e9151eb" id="field-604a1910e9151eb" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Ketibaan Pengantin/Waktu Bersanding:</strong>
</td>
<td valign="top">
<input type="text" name="field-a04e3065a0e2736" id="field-a04e3065a0e2736" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Turut Mengundang:
Seisi Keluarga</strong>
</td>
<td valign="top">
<input type="text" name="field-1f2807f49b5de12" id="field-1f2807f49b5de12" size="40" value="" />
</td>
</tr>
<tr>
<td valign="top">
<strong>Alamat Majlis:</strong>
</td>
<td valign="top">
<textarea name="field-48cf0a11ec4d733" id="field-48cf0a11ec4d733" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td valign="top">
<strong>Hubungi: (cth, ahli keluarga pengantin)</strong>
</td>
<td valign="top">
<textarea name="field-cab434fa9a77f82" id="field-cab434fa9a77f82" rows="6" cols="40"></textarea>
</td>
</tr>
<tr>
<td colspan="2" valign="top">
<strong><p><strong>Maklumat Pengantin Perempuan</strong></p></strong>
</td>
</tr><tr>
<td colspan="2" valign="top">
<strong></strong>
</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 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">Click here</a> to put a form like this on your site.
</b></font></center>
<!-- End Response-O-Matic Form -->
