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<HTML><HEAD><TITLE>MyAccount</TITLE></HEAD>
<BODY BGCOLOR="#eeeeee"><FONT SIZE=5>MyAccount</FONT><BR><BR>
<%= $url = "$selfurl?session=$session_id;action="; ''; %>
<%= include('myaccount_menu') %>
<TD VALIGN="top">
<FONT SIZE=4>Recharge with prepaid card</FONT><BR><BR>
<FORM NAME="OneTrueForm" METHOD="POST" ACTION="<%=$selfurl%>" onSubmit="document.OneTrueForm.process.disabled=true">
<INPUT TYPE="hidden" NAME="session" VALUE="<%=$session_id%>">
<INPUT TYPE="hidden" NAME="action" VALUE="recharge_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">Prepaid card number</TD>
<TD>
<INPUT TYPE="text" NAME="prepaid_cardnum" SIZE=20 MAXLENGTH=19 VALUE="<%=$prepaid_cardnum%>">
</TD>
</TR>
</TABLE>
<BR>
<INPUT TYPE="hidden" NAME="paybatch" VALUE="<%=$paybatch%>">
<INPUT TYPE="submit" NAME="process" VALUE="Recharge"> <!-- onClick="this.disabled=true"> -->
</FORM>
</TD></TR></TABLE>
<HR>
<FONT SIZE="-2">powered by <a href="http://www.sisd.com/freeside">freeside</a></FONT>
</BODY></HTML>
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