The Acme Widget Company

Get Your Widgets Here!

Please make your selections from the following choices:

Please tell us who you are (red denotes required information):

Email (Your confirmation will be sent here):  
Other Contact Info:  

And tell us what you would like:

Item Description Quantity Price Total
Class "A" Widgets 1.25
Class "B" Widgets 2.35
Class "C" Widgets 3.45






If you have questions or difficulties with this order page,
 please contact our Customer Service Department (see our Contacts page.)