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Please enter your shipping information to complete your order.
  <form action="/redeem/update_shipping"  style="margin-top:10px">
    <div class="dialog_data table">
	<div class="dialog_data1 cell">First Name</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_first_name" name="shipping_address[first_name]" size="30" type="text" />
		
	</div>
</div>
  	<div class="dialog_data table">
	<div class="dialog_data1 cell">Last Name</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_last_name" name="shipping_address[last_name]" size="30" type="text" />
		
	</div>
</div>
    	<div class="dialog_data table">
	<div class="dialog_data1 cell">Address 1</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_address_1" name="shipping_address[address_1]" size="30" type="text" />
		
	</div>
</div>
  	<div class="dialog_data table">
	<div class="dialog_data1 cell">Address 2</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_address_2" name="shipping_address[address_2]" size="30" type="text" />
		
	</div>
</div>
  	<div class="dialog_data table">
	<div class="dialog_data1 cell">City</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_city" name="shipping_address[city]" size="30" type="text" />
		
	</div>
</div>
  	<div class="dialog_data table">
	<div class="dialog_data1 cell">State</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_state" name="shipping_address[state]" size="30" type="text" />
		
	</div>
</div>
  	<div class="dialog_data table">
	<div class="dialog_data1 cell">Zip Code</div>
	<div class="dialog_data2 cell">
		<input id="shipping_address_zip" name="shipping_address[zip]" size="30" type="text" />
		
	</div>
</div>
    </form>