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<TABLE CLASS="fsinnerbox">
% if ( $opt{'phonenum'} ) {
<INPUT TYPE="hidden" NAME="loop_type" VALUE="">
<INPUT TYPE="hidden" NAME="phonenum" VALUE="<% $opt{'phonenum'} %>">
<TR>
<TH ALIGN="right">Loop Type</TD>
<TD BGCOLOR="#eeeeee">Line-share</TD>
</TR>
<TR>
<TH ALIGN="right">Phone Number</TD>
<TD BGCOLOR="#eeeeee"><% $opt{'phonenum'} %></TD>
</TR>
% } else {
<INPUT TYPE="hidden" NAME="loop_type" VALUE="0">
<INPUT TYPE="hidden" NAME="phonenum" VALUE="">
<TR>
<TH ALIGN="right">Loop Type</TD>
<TD BGCOLOR="#eeeeee">Standalone</TD>
</TR>
% }
<TR>
<TH ALIGN="right">PPPoE password</TD>
<TD>
<INPUT TYPE = "text"
NAME = "password"
VALUE = "<% $opt{'password'} %>"
>
</TD>
</TR>
<TR>
<TH ALIGN="right">ISP Changing?</TD>
<TD>
<INPUT TYPE = "checkbox"
NAME = "isp_chg"
VALUE = "Y"
<% $opt{'isp_chg'} eq 'Y' ? 'CHECKED' : '' %>
>
</TD>
</TR>
<TR>
<TH ALIGN="right">Current or Previous ISP</TD>
<TD>
<INPUT TYPE = "text"
NAME = "isp_prev"
VALUE = "<% $opt{'isp_prev'} %>"
>
</TD>
</TR>
<INPUT TYPE="hidden" NAME="vendor_qual_id" VALUE="<% $opt{'vendor_qual_id'} %>">
<TR>
<TH ALIGN="right">Vendor Qualification ID</TD>
<TD BGCOLOR="#eeeeee"><% $opt{'vendor_qual_id'} %></TD>
</TR>
</TABLE>
<%init>
my %opt = @_;
#my $conf = new FS::Conf;
</%init>
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