diff options
Diffstat (limited to 'fs_selfservice/FS-SelfService/cgi/signup-agentselect.html')
| -rwxr-xr-x | fs_selfservice/FS-SelfService/cgi/signup-agentselect.html | 195 |
1 files changed, 0 insertions, 195 deletions
diff --git a/fs_selfservice/FS-SelfService/cgi/signup-agentselect.html b/fs_selfservice/FS-SelfService/cgi/signup-agentselect.html deleted file mode 100755 index 7851c56..0000000 --- a/fs_selfservice/FS-SelfService/cgi/signup-agentselect.html +++ /dev/null @@ -1,195 +0,0 @@ -<HTML><HEAD><TITLE>ISP Signup form</TITLE></HEAD> -<BODY BGCOLOR="#e8e8e8"><FONT SIZE=7>ISP Signup form</FONT><BR><BR> -<FONT SIZE="+1" COLOR="#ff0000"><%= $error %></FONT> -<FORM NAME="OneTrueForm" ACTION="<%= $self_url %>" METHOD=POST onSubmit="document.OneTrueForm.signup.disabled=true"> -<INPUT TYPE="hidden" NAME="magic" VALUE="process"> -<INPUT TYPE="hidden" NAME="ref" VALUE="<%= $referral_custnum %>"> -<INPUT TYPE="hidden" NAME="ss" VALUE=""> -Agent <SELECT NAME="agentnum"> -<%= - warn $init_data; - warn $init_data->{'agent'}; - foreach my $agent ( @{$init_data->{'agent'}} ) { - $OUT .= '<OPTION VALUE="'. $agent->{'agentnum'}. '"'; - $OUT .= ' SELECTED' if $agent->{'agentnum'} eq $agentnum; - $OUT .= '>'. $agent->{'agent'}; - } -%> -</SELECT><BR><BR> -Contact Information -<TABLE BGCOLOR="#c0c0c0" BORDER=0 CELLSPACING=0 WIDTH="100%"> -<TR> - <TH ALIGN="right"><font color="#ff0000">*</font>Contact name<BR>(last, first)</TH> - <TD COLSPAN=5><INPUT TYPE="text" NAME="last" VALUE="<%= $last %>">, - <INPUT TYPE="text" NAME="first" VALUE="<%= $first %>"></TD> -</TR> -<TR> - <TD ALIGN="right">Company</TD> - <TD COLSPAN=5><INPUT TYPE="text" NAME="company" SIZE=70 VALUE="<%= $company %>"></TD> -</TR> -<TR> - <TH ALIGN="right"><font color="#ff0000">*</font>Address</TH> - <TD COLSPAN=5><INPUT TYPE="text" NAME="address1" SIZE=70 VALUE="<%= $address1 %>"></TD> -</TR> -<TR> - <TD ALIGN="right"> </TD> - <TD COLSPAN=5><INPUT TYPE="text" NAME="address2" SIZE=70 VALUE="<%= $address2 %>"></TD> -</TR> -<TR> - <TH ALIGN="right"><font color="#ff0000">*</font>City</TH> - <TD><INPUT TYPE="text" NAME="city" VALUE="<%= $city %>"></TD> - <TH ALIGN="right"><font color="#ff0000">*</font>State/Country</TH> - <TD> - <%= - ($county_html, $state_html, $country_html) = - regionselector( $county, $state, $country ); - - "$county_html $state_html"; - %> - </TD> - <TH><font color="#ff0000">*</font>Zip</TH> - <TD><INPUT TYPE="text" NAME="zip" SIZE=10 VALUE="<%= $zip %>"></TD> -</TR> -<TR> - <TH ALIGN="right"><font color="#ff0000">*</font>Country</TH> - <TD><%= $country_html %></TD> -<TR> - <TD ALIGN="right">Day Phone</TD> - <TD COLSPAN=5><INPUT TYPE="text" NAME="daytime" VALUE="<%= $daytime %>" SIZE=18></TD> -</TR> -<TR> - <TD ALIGN="right">Night Phone</TD> - <TD COLSPAN=5><INPUT TYPE="text" NAME="night" VALUE="<%= $night %>" SIZE=18></TD> -</TR> -<TR> - <TD ALIGN="right">Fax</TD> - <TD COLSPAN=5><INPUT TYPE="text" NAME="fax" VALUE="<%= $fax %>" SIZE=12></TD> -</TR> -</TABLE><font color="#ff0000">*</font> required fields<BR> -<BR>Billing information<TABLE BGCOLOR="#c0c0c0" BORDER=0 CELLSPACING=0 WIDTH="100%"> -<TR><TD> - - <%= - $OUT .= '<INPUT TYPE="checkbox" NAME="invoicing_list_POST" VALUE="POST"'; - my @invoicing_list = split(', ', $invoicing_list ); - $OUT .= ' CHECKED' - if ! @invoicing_list || grep { $_ eq 'POST' } @invoicing_list; - $OUT .= '>'; - %> - - Postal mail invoice -</TD></TR> -<TR><TD>Email invoice <INPUT TYPE="text" NAME="invoicing_list" VALUE="<%= join(', ', grep { $_ ne 'POST' } split(', ', $invoicing_list ) ) %>"> -</TD></TR> -<%= scalar(@payby) > 1 ? '<TR><TD>Billing type</TD></TR>' : '' %> -</TABLE> -<TABLE BGCOLOR="#c0c0c0" BORDER=1 WIDTH="100%"> -<TR> - - <%= - - my $cardselect = '<SELECT NAME="CARD_type"><OPTION></OPTION>'; - my %types = ( - 'VISA' => 'VISA card', - 'MasterCard' => 'MasterCard', - 'Discover' => 'Discover card', - 'American Express' => 'American Express card', - ); - foreach ( keys %types ) { - $selected = $cgi->param('CARD_type') eq $types{$_} ? 'SELECTED' : ''; - $cardselect .= qq!<OPTION $selected VALUE="$types{$_}">$_</OPTION>!; - } - $cardselect .= '</SELECT>'; - - my %payby = ( - 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="CARD_payinfo" VALUE="" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD"). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="">!, - 'DCRD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="DCRD_payinfo" VALUE="" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("DCRD"). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="DCRD_payname" VALUE="">!, - 'CHEK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="CHEK_payinfo1" VALUE="" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="CHEK_payinfo2" VALUE="" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="CHEK_month" VALUE="12"><INPUT TYPE="hidden" NAME="CHEK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="CHEK_payname" VALUE="">!, - 'DCHK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="DCHK_payinfo1" VALUE="" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="DCHK_payinfo2" VALUE="" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="DCHK_month" VALUE="12"><INPUT TYPE="hidden" NAME="DCHK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="DCHK_payname" VALUE="">!, - 'LECB' => qq!Phone bill billing<BR>${r}Phone number <INPUT TYPE="text" BANE="LECB_payinfo" VALUE="" MAXLENGTH=15 SIZE=16><INPUT TYPE="hidden" NAME="LECB_month" VALUE="12"><INPUT TYPE="hidden" NAME="LECB_year" VALUE="2037"><INPUT TYPE="hidden" NAME="LECB_payname" VALUE="">!, - 'BILL' => qq!Billing<BR>P.O. <INPUT TYPE="text" NAME="BILL_payinfo" VALUE=""><BR><font color="#ff0000">*</font>Exp !. expselect("BILL", "12-2037"). qq!<BR><font color="#ff0000">*</font>Attention<BR><INPUT TYPE="text" NAME="BILL_payname" VALUE="Accounts Payable">!, - 'COMP' => qq!Complimentary<BR><font color="#ff0000">*</font>Approved by<INPUT TYPE="text" NAME="COMP_payinfo" VALUE=""><BR><font color="#ff0000">*</font>Exp !. expselect("COMP"), - 'PREPAY' => qq!Prepaid card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="PREPAY_payinfo" VALUE="" MAXLENGTH=80>!, - ); - - my( $account, $aba ) = split('@', $payinfo); - my %paybychecked = ( - 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="CARD_payinfo" VALUE="$payinfo" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD", $paydate). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="$payname">!, - 'DCRD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="DCRD_payinfo" VALUE="$payinfo" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("DCRD", $paydate). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="DCRD_payname" VALUE="$payname">!, - 'CHEK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="CHEK_payinfo1" VALUE="$account" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="CHEK_payinfo2" VALUE="$aba" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="CHEK_month" VALUE="12"><INPUT TYPE="hidden" NAME="CHEK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="CHEK_payname" VALUE="$payname">!, - 'DCHK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="DCHK_payinfo1" VALUE="$account" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="DCHK_payinfo2" VALUE="$aba" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="DCHK_month" VALUE="12"><INPUT TYPE="hidden" NAME="DCHK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="DCHK_payname" VALUE="$payname">!, - 'LECB' => qq!Phone bill billing<BR>${r}Phone number <INPUT TYPE="text" BANE="LECB_payinfo" VALUE="$payinfo" MAXLENGTH=15 SIZE=16><INPUT TYPE="hidden" NAME="LECB_month" VALUE="12"><INPUT TYPE="hidden" NAME="LECB_year" VALUE="2037"><INPUT TYPE="hidden" NAME="LECB_payname" VALUE="">!, - 'BILL' => qq!Billing<BR>P.O. <INPUT TYPE="text" NAME="BILL_payinfo" VALUE="$payinfo"><BR><font color="#ff0000">*</font>Exp !. expselect("BILL", $paydate). qq!<BR><font color="#ff0000">*</font>Attention<BR><INPUT TYPE="text" NAME="BILL_payname" VALUE="$payname">!, - 'COMP' => qq!Complimentary<BR><font color="#ff0000">*</font>Approved by<INPUT TYPE="text" NAME="COMP_payinfo" VALUE="$payinfo"><BR><font color="#ff0000">*</font>Exp !. expselect("COMP", $paydate), - 'PREPAY' => qq!Prepaid card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="PREPAY_payinfo" VALUE="$payinfo" MAXLENGTH=80>!, - ); - - for (@payby) { - if ( scalar(@payby) == 1) { - $OUT .= '<TD VALIGN=TOP>'. - qq!<INPUT TYPE="hidden" NAME="payby" VALUE="$_">!. - "$paybychecked{$_}</TD>"; - } else { - $OUT .= qq!<TD VALIGN=TOP><INPUT TYPE="radio" NAME="payby" VALUE="$_"!; - if ($payby eq $_) { - $OUT .= qq! CHECKED> $paybychecked{$_}</TD>!; - } else { - $OUT .= qq!> $payby{$_}</TD>!; - } - - } - } - %> - -</TR></TABLE><font color="#ff0000">*</font> required fields for each billing type -<BR><BR>First package -<TABLE BGCOLOR="#c0c0c0" BORDER=0 CELLSPACING=0 WIDTH="100%"> -<TR> - <TD COLSPAN=2><SELECT NAME="pkgpart"><OPTION VALUE="">(none) - - <%= - foreach my $package ( @{$packages} ) { - $OUT .= '<OPTION VALUE="'. $package->{'pkgpart'}. '"'; - $OUT .= ' SELECTED' if $pkgpart && $package->{'pkgpart'} == $pkgpart; - $OUT .= '>'. $package->{'pkg'}; - } - %> - - </SELECT></TD> -</TR> -<TR> - <TD ALIGN="right">Username</TD> - <TD><INPUT TYPE="text" NAME="username" VALUE="<%= $username %>"></TD> -</TR> -<TR> - <TD ALIGN="right">Password</TD> - <TD><INPUT TYPE="password" NAME="_password" VALUE="<%= $password %>"></TD> -</TR> -<TR> - <TD ALIGN="right">Re-enter Password</TD> - <TD><INPUT TYPE="password" NAME="_password2" VALUE="<%= $password2 %>"></TD> -</TR> -<%= - if ( $init_data->{'security_phrase'} ) { - $OUT .= <<ENDOUT; -<TR> - <TD ALIGN="right">Security Phrase</TD> - <TD><INPUT TYPE="text" NAME="sec_phrase" VALUE="$sec_phrase"> - </TD> -</TR> -ENDOUT - } else { - $OUT .= '<INPUT TYPE="hidden" NAME="sec_phrase" VALUE="">'; - } -%> -<%= - if ( scalar(@$pops) ) { - $OUT .= '<TR><TD ALIGN="right">Access number</TD><TD>'. - popselector($popnum). '</TD></TR>'; - } else { - $OUT .= popselector($popnum); - } -%> -</TABLE> -<BR><BR><INPUT TYPE="submit" NAME="signup" VALUE="Signup" > -</FORM></BODY></HTML> |