diff options
Diffstat (limited to 'fs_signup/FS-SignupClient/cgi/signup.html')
| -rwxr-xr-x | fs_signup/FS-SignupClient/cgi/signup.html | 73 |
1 files changed, 56 insertions, 17 deletions
diff --git a/fs_signup/FS-SignupClient/cgi/signup.html b/fs_signup/FS-SignupClient/cgi/signup.html index 6c601410c..96bdac666 100755 --- a/fs_signup/FS-SignupClient/cgi/signup.html +++ b/fs_signup/FS-SignupClient/cgi/signup.html @@ -1,10 +1,33 @@ <HTML><HEAD><TITLE>ISP Signup form</TITLE></HEAD> -<BODY BGCOLOR="#e8e8e8"><FONT SIZE=7>ISP Signup form</FONT><BR><BR> +<BODY BGCOLOR="#e8e8e8" onUnload="myclose()"> +<script language="JavaScript"><!-- + var mywindow = -1; + function myopen(filename,windowname,properties) { + myclose(); + mywindow = window.open(filename,windowname,properties); + } + function myclose() { + if ( mywindow != -1 ) + mywindow.close(); + mywindow = -1 + } +//--></script> +<FONT SIZE=7>ISP Signup form</FONT><BR><BR> <FONT SIZE="+1" COLOR="#ff0000"><%= $error %></FONT> <FORM ACTION="<%= $self_url %>" METHOD=POST> <INPUT TYPE="hidden" NAME="magic" VALUE="process"> <INPUT TYPE="hidden" NAME="ref" VALUE="<%= $referral_custnum %>"> <INPUT TYPE="hidden" NAME="ss" VALUE=""> +Where did you hear about our service? <SELECT NAME="refnum"> +<%= + $OUT .= '<OPTION VALUE="">' unless $refnum; + foreach my $part_referral ( @{$init_data->{'part_referral'}} ) { + $OUT .= '<OPTION VALUE="'. $part_referral->{'refnum'}. '"'; + $OUT .= ' SELECTED' if $part_referral->{'refnum'} eq $refnum; + $OUT .= '>'. $part_referral->{'referral'}; + } +%> +</SELECT><BR><BR> Contact Information <TABLE BGCOLOR="#c0c0c0" BORDER=0 CELLSPACING=0 WIDTH="100%"> <TR> @@ -28,26 +51,21 @@ Contact Information <TH ALIGN="right"><font color="#ff0000">*</font>City</TH> <TD><INPUT TYPE="text" NAME="city" VALUE="<%= $city %>"></TD> <TH ALIGN="right"><font color="#ff0000">*</font>State/Country</TH> - <TD><SELECT NAME="state" SIZE="1"> - - <%= - foreach ( @{$locales} ) { - $OUT .= '<OPTION'; - $OUT .= ' SELECTED' if ( $state eq $_->{'state'} - && $county eq $_->{'county'} - && $country eq $_->{'country'} - ); - $OUT .= '>'. $_->{'state'}; - $OUT .= ' ('. $_->{'county'}. ')' if $_->{'county'}; - $OUT .= ' / '. $_->{'country'}; - } - %> - - </SELECT></TD> + <TD> + <%= + ($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="<%= $daytime %>" SIZE=18></TD> </TR> @@ -97,18 +115,39 @@ Contact Information my %payby = ( 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font>$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>!, ); + if ( $init_data->{'cvv_enabled'} ) { + foreach my $payby ( grep { exists $payby{$_} } qw(CARD DCRD) ) { #1.4/1.5 + $payby{$payby} .= qq!<BR>CVV2 (<A HREF="javascript:myopen('cvv2.html','cvv2','toolbar=no,location=no,directories=no,status=no,menubar=no,scrollbars=no,resizable=yes,copyhistory=no,width=480,height=288')">help</A>) <INPUT TYPE="text" NAME=${payby}_paycvv VALUE="" SIZE=4 MAXLENGTH=4>!; + } + } + + 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>!, ); + if ( $init_data->{'cvv_enabled'} ) { + foreach my $payby ( grep { exists $payby{$_} } qw(CARD DCRD) ) { #1.4/1.5 + $paybychecked{$payby} .= qq!<BR>CVV2 (<A HREF="javascript:myopen('cvv2.html','cvv2','toolbar=no,location=no,directories=no,status=no,menubar=no,scrollbars=no,resizable=yes,copyhistory=no,width=480,height=288')">help</A>) <INPUT TYPE="text" NAME=${payby}_paycvv VALUE="$paycvv" SIZE=4 MAXLENGTH=4>!; + } + } + for (@payby) { if ( scalar(@payby) == 1) { $OUT .= '<TD VALIGN=TOP>'. |