diff options
Diffstat (limited to 'fs_selfservice/FS-SelfService/cgi/bill.html')
| -rw-r--r-- | fs_selfservice/FS-SelfService/cgi/bill.html | 15 |
1 files changed, 15 insertions, 0 deletions
diff --git a/fs_selfservice/FS-SelfService/cgi/bill.html b/fs_selfservice/FS-SelfService/cgi/bill.html new file mode 100644 index 000000000..a3884e0f2 --- /dev/null +++ b/fs_selfservice/FS-SelfService/cgi/bill.html @@ -0,0 +1,15 @@ +<TR> + <TD ALIGN="right">P.O. number</TD> + <TD><INPUT TYPE="text" NAME="payinfo" SIZE=10 MAXLENGTH=20 VALUE="<%=$payinfo%>"></TD> +</TR><TR> + <TD ALIGN="right">Attention</TD> + <TD><INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<%=$payname%>"></TD> +</TR><TR> + <TD ALIGN="right">Postal mail invoice</TD> + <TD><INPUT TYPE="checkbox" NAME="postal_invoicing" VALUE="POST" <%= + $postal_invoicing ? 'CHECKED' : '' + %>></TD> +</TR><TR> + <TD>Email address(es)</TD> + <TD><INPUT TYPE="text" NAME="invoicing_list" VALUE="<%= join(',', $invoicing_list ) %>"></TD> +</TR> |