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<% &ntable("#cccccc") %>
<TR>
<TH ALIGN="right"><%$r%>Contact name<BR>(last, first)</TH>
<TD COLSPAN=5>
<INPUT TYPE="text" NAME="<%$pre%>last" VALUE="<% $cust_main->get($pre.'last') %>" onChange="<% $onchange %>" <%$disabled%>> ,
<INPUT TYPE="text" NAME="<%$pre%>first" VALUE="<% $cust_main->get($pre.'first') %>" onChange="<% $onchange %>" <%$disabled%>>
</TD>
% if ( $conf->exists('show_ss') && !$pre ) {
<TD ALIGN="right">SS#</TD>
<TD><INPUT TYPE="text" NAME="ss" VALUE="<% $cust_main->ss %>" SIZE=11></TD>
% } elsif ( !$pre ) {
<TD><INPUT TYPE="hidden" NAME="ss" VALUE="<% $cust_main->ss %>"></TD>
% }
</TR>
<TR>
<TD ALIGN="right">Company</TD>
<TD COLSPAN=7>
<INPUT TYPE="text" NAME="<%$pre%>company" VALUE="<% $cust_main->get($pre.'company') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TH ALIGN="right"><%$r%>Address</TH>
<TD COLSPAN=7>
<INPUT TYPE="text" NAME="<%$pre%>address1" VALUE="<% $cust_main->get($pre.'address1') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TD ALIGN="right"> </TD>
<TD COLSPAN=7>
<INPUT TYPE="text" NAME="<%$pre%>address2" VALUE="<% $cust_main->get($pre.'address2') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TH ALIGN="right"><%$r%>City</TH>
<TD>
<INPUT TYPE="text" NAME="<%$pre%>city" VALUE="<% $cust_main->get($pre.'city') %>" onChange="<% $onchange %>" <%$disabled%>>
</TD>
<TH ALIGN="right" ID="<%$pre%>countylabel" <%$county_style%>><%$r%>County</TH>
<TD>
<% include('select-county.html', %select_hash ) %>
</TD>
<TH ALIGN="right"><%$r%>State</TH>
<TD>
<% include('select-state.html', %select_hash ) %>
</TD>
<TH><%$r%>Zip</TH>
<TD>
<INPUT TYPE="text" NAME="<%$pre%>zip" VALUE="<% $cust_main->get($pre.'zip') %>" SIZE=10 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TH ALIGN="right"><%$r%>Country</TH>
<TD COLSPAN=5><% include('select-country.html', %select_hash ) %></TD>
</TR>
<TR>
<TD ALIGN="right"><% $daytime_label %></TD>
<TD COLSPAN=5>
<INPUT TYPE="text" NAME="<%$pre%>daytime" VALUE="<% $cust_main->get($pre.'daytime') %>" SIZE=18 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TD ALIGN="right"><% $night_label %></TD>
<TD COLSPAN=5>
<INPUT TYPE="text" NAME="<%$pre%>night" VALUE="<% $cust_main->get($pre.'night') %>" SIZE=18 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
<TR>
<TD ALIGN="right">Fax</TD>
<TD COLSPAN=5>
<INPUT TYPE="text" NAME="<%$pre%>fax" VALUE="<% $cust_main->get($pre.'fax') %>" SIZE=12 onChange="<% $onchange %>" <%$disabled%>>
</TD>
</TR>
</TABLE>
<%$r%>required fields<BR>
<%init>
my( $cust_main, $pre, $onchange, $disabled ) = @_;
my $conf = new FS::Conf;
#false laziness with ship state
my $countrydefault = $conf->config('countrydefault') || 'US';
$cust_main->set($pre.'country', $countrydefault )
unless $cust_main->get($pre.'country');
my $statedefault = $conf->config('statedefault')
|| ($countrydefault eq 'US' ? 'CA' : '');
$cust_main->set($pre.'state', $statedefault )
unless $cust_main->get($pre.'state')
|| $cust_main->get($pre.'country') ne $countrydefault;
#my($county_html, $state_html, $country_html) =
# FS::cust_main_county::regionselector( $cust_main->get($pre.'county'),
# $cust_main->get($pre.'state'),
# $cust_main->get($pre.'country'),
# $pre,
# $onchange,
# $disabled,
# );
my %select_hash = (
'county' => $cust_main->get($pre.'county'),
'state' => $cust_main->get($pre.'state'),
'country' => $cust_main->get($pre.'country'),
'prefix' => $pre,
'onchange' => $onchange,
'disabled' => $disabled,
);
my @counties = counties( $cust_main->get($pre.'state'),
$cust_main->get($pre.'country'),
);
my $county_style = scalar(@counties) > 1 ? '' : 'STYLE="visibility:hidden"';
my $daytime_label = FS::Msgcat::_gettext('daytime') || 'Day Phone';
my $night_label = FS::Msgcat::_gettext('night') || 'Night Phone';
my $r = qq!<font color="#ff0000">*</font> !;
</%init>
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