When you are entering information that requires numbers (ie. street address, ZIP, etc) enter a NON-NUMERICAL character first, such as an _ (underscore). Do not use a space. For example, instead of entering 123 Maple Lane Drive, enter _123 Maple Lane Drive. An unresolved bug within some browsers causes entries begining with numbers to be partially deleted.
To be able to use this order form it is needed that your mail (SMTP) server is specified in your browser configuration. If the form still does not work for you cut and paste the content of this page to an email, edit it and email it to me.