1 <%= include('header', 'Recharge with prepaid card') %>
3 <FORM NAME="OneTrueForm" METHOD="POST" ACTION="<%=$selfurl%>" onSubmit="document.OneTrueForm.process.disabled=true">
4 <INPUT TYPE="hidden" NAME="action" VALUE="recharge_results">
5 <TABLE BGCOLOR="#cccccc">
8 <TD ALIGN="right">Amount Due</TD>
10 <TABLE><TR><TD BGCOLOR="#ffffff">
11 $<%=sprintf("%.2f",$balance)%>
17 <TD ALIGN="right">Prepaid card number</TD>
19 <INPUT TYPE="text" NAME="prepaid_cardnum" SIZE=20 MAXLENGTH=19 VALUE="<%=$prepaid_cardnum%>">
24 <INPUT TYPE="hidden" NAME="paybatch" VALUE="<%=$paybatch%>">
25 <INPUT TYPE="submit" NAME="process" VALUE="Recharge"> <!-- onClick="this.disabled=true"> -->
28 <%= include('footer') %>