diff options
Diffstat (limited to 'fs_selfservice/FS-SelfService/cgi/make_payment.html')
| -rw-r--r-- | fs_selfservice/FS-SelfService/cgi/make_payment.html | 109 |
1 files changed, 4 insertions, 105 deletions
diff --git a/fs_selfservice/FS-SelfService/cgi/make_payment.html b/fs_selfservice/FS-SelfService/cgi/make_payment.html index 40cd83c6f..a5e24291d 100644 --- a/fs_selfservice/FS-SelfService/cgi/make_payment.html +++ b/fs_selfservice/FS-SelfService/cgi/make_payment.html @@ -6,112 +6,11 @@ <!-- <A HREF="<%= $url %>other">SomethingElse</A><BR> --> </TD><TD VALIGN="top"> <FONT SIZE=4>Make a payment</FONT><BR><BR> -<FORM NAME="OneTrueForm" METHOD="POST" ACTION="<%=$selfurl%>" onSubmit="document.OneTrueForm.process.disabled=true"> +<FORM METHOD="POST" ACTION="<%=$selfurl%>"> <INPUT TYPE="hidden" NAME="session" VALUE="<%=$session_id%>"> -<INPUT TYPE="hidden" NAME="action" VALUE="payment_results"> -<TABLE BGCOLOR="#cccccc"> -<TR> - <TD ALIGN="right">Amount Due</TD> - <TD> - <TABLE><TR><TD BGCOLOR="#ffffff"> - $<%=sprintf("%.2f",$balance)%> - </TD></TR></TABLE> - </TD> -</TR> -<TR> - <TD ALIGN="right">Payment amount</TD> - <TD> - <TABLE><TR><TD BGCOLOR="#ffffff"> - $<INPUT TYPE="text" NAME="amount" SIZE=8 VALUE="<%=sprintf("%.2f",$balance)%>"> - </TD></TR></TABLE> - </TD> -</TR><TR> - <TD ALIGN="right">Card type</TD> - <TD> - <SELECT NAME="card_type"><OPTION></OPTION> - <%= foreach ( keys %card_types ) { - $selected = $card_type eq $card_types{$_} ? ' SELECTED' : ''; - $OUT .= qq(<OPTION$selected VALUE="). $card_types{$_}. qq(">$_\n); - } %> - </SELECT> - </TD> -</TD><TR> - <TD ALIGN="right">Card number</TD> - <TD> - <TABLE> - <TR> - <TD> - <INPUT TYPE="text" NAME="payinfo" SIZE=20 MAXLENGTH=19 VALUE="<%=$payinfo%>"> </TD> - <TD>Exp.</TD> - <TD> - <SELECT NAME="month"> - <%= for ( ( map "0$_", 1 .. 9 ), 11, 12 ) { - $OUT .= '<OPTION'. ($_ eq $month ? ' SELECTED' : ''). ">$_\n"; - } %> - </SELECT> - </TD> - <TD> / </TD> - <TD> - <SELECT NAME="year"> - <%= my @a = localtime; for ( $a[5]+1900 .. $a[5]+1915 ) { - $OUT .= '<OPTION'. ($_ eq $year ? ' SELECTED' : ''). ">$_\n"; - } %> - </SELECT> - </TD> - </TR> - </TABLE> - </TD> -</TR><TR> - <TD ALIGN="right">Exact name on card</TD> - <TD><INPUT TYPE="text" SIZE=32 MAXLENGTH=80 NAME="payname" VALUE="<%=$payname%>"></TD> -</TR><TR> - <TD ALIGN="right">Card billing address</TD> - <TD> - <INPUT TYPE="text" SIZE=40 MAXLENGTH=80 NAME="address1" VALUE="<%=$address1%>"> - </TD> -</TR><TR> - <TD ALIGN="right">Address line 2</TD> - <TD> - <INPUT TYPE="text" SIZE=40 MAXLENGTH=80 NAME="address2" VALUE="<%=$address2%>"> - </TD> -</TR><TR> - <TD ALIGN="right">City</TD> - <TD> - <TABLE> - <TR> - <TD> - <INPUT TYPE="text" NAME="city" SIZE="12" MAXLENGTH=80 VALUE="<%=$city%>"> - </TD> - <TD>State</TD> - <TD> - <SELECT NAME="state"> - <%= for ( @states ) { - $OUT .= '<OPTION'. ($_ eq $state ? ' SELECTED' : '' ). ">$_\n"; - } %> - </SELECT> - </TD> - <TD>Zip</TD> - <TD> - <INPUT TYPE="text" NAME="zip" SIZE=11 MAXLENGTH=10 VALUE="<%=$zip%>"> - </TD> - </TR> - </TABLE> - </TD> -</TR><TR> - <TD COLSPAN=2> - <INPUT TYPE="checkbox" CHECKED NAME="save" VALUE="1"> - Remember this information - </TD> -</TR><TR> - <TD COLSPAN=2> - <INPUT TYPE="checkbox"<%= $payby eq 'CARD' ? ' CHECKED' : '' %> NAME="auto" VALUE="1" onClick="if (this.checked) { document.OneTrueForm.save.checked=true; }"> - Charge future payments to this card automatically - </TD> -</TR> -</TABLE> -<BR> -<INPUT TYPE="hidden" NAME="paybatch" VALUE="<%=$paybatch%>"> -<INPUT TYPE="submit" NAME="process" VALUE="Process payment"> <!-- onClick="this.disabled=true"> --> +<INPUT TYPE="hidden" NAME="action" VALUE="process_payment"> +Amount: <INPUT TYPE="text" VALUE="<%=sprintf("%.2f",$balance)%>"><BR><BR> +<INPUT TYPE="submit" VALUE="Process payment"> </FORM> </TD></TR></TABLE> <HR> |