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[null,null,"If you need assistance, please call:"]
[null,null,"Phone: +32 (0)28 96 28 53"]
[null,null,"To call from the US: 1-888-261-2064 ext.1"]
[]
[]
["Multiple Shipment Order Form"]
["         1. Please fill in your billing information and gift recipients' information. You do not need to fill in the \"Price\" and \"Delivery Price\"."]
["         2. E-mail your completed order to us at sales@frucon.net with \"Multiple Order Form\" as the subject"]
["         3. Customer service will contact you to obtain your creditcard information and to confirm your order."]
[]
["Billing information"]
["Today's date:"]
["Your Name (*) :",{"$nulls":3},"(*) = denotes obligatory field"]
["Your Phone (*) :"]
["Your Email (*) :"]
["Your Company Name:"]
["Street Address1 (*)"]
["Street Address2 (*) :"]
["City (*) :"]
["State (*) :"]
["Zip (*) :"]
["Advice Currency (*) :"]
[]
["Enter Gifts & Recipients Delivery Information Below (* required fields)"]
["Order","Company","First Name (*)","Last Name (*)","Address line 1 (*) :","Address line 2","Zipcode (*)","City (*)","State","Country (*)","Phone (*)","E-mail","Product / Gift","Quantity","Price","Delivery Price","Expected Delivery date","Sender","Message"]
["1","The Bookhouse","Bobby M.","Brown","78 State Street",null,27510,"Chapel Hill","NC","USA",15068965421,null,"Fresh Cream Ballotin 470 g",1,"80",17,"2009/12/24","Jim Delat, CEO The Bookhouse","Thank you very much for your business."]