Checkout \ Progressive — Responsive Multipurpose HTML Template

1

Checkout Method
Checkout as a Guest or Register

Register with us for future convenience:

Checkout as Guest Register

Register and save time!
Register with us for future convenience:

Fast and easy check out

Easy access to your order history and status
Login

If you have an account with us, please log in.

Email Adress: * Password: * Remember password

Forgot Your Password? * Required Field
2

Billing Information

First Name: *

Last Name: *

Company:

Email Address: *

Address: *

City

Telephone: *

Fax:

Password: *

Confirm Password: *

* Required Field
3

Shipping Information

First Name: *

Last Name: *

Company:

Telephone: *

Address: *

City

Zip/Postal Code: *

Country

* Required Field
4

Shipping Method

Flat Rate

Fixed $5.00
5

Payment Information

Checkout as Guest Register

* Required Field

Order Review

Product Name	Price	Qty	Subtotal
Samsung Galaxy Note 2	$499.00	1	$499.00
Sony Led TV KDL-46HX853	$1199.00	1	$1199.00
Subtotal			$1698.00
Shipping & Handling (Flat Rate - Fixed)			$5.00
Grand Total			$1703.00