3 %my( $cust_main, $pre, $onchange, $disabled ) = @_;
4 %my $conf = new FS::Conf;
6 %#false laziness with ship state
7 %my $countrydefault = $conf->config('countrydefault') || 'US';
8 %$cust_main->set($pre.'country', $countrydefault )
9 % unless $cust_main->get($pre.'country');
11 %my $statedefault = $conf->config('statedefault')
12 % || ($countrydefault eq 'US' ? 'CA' : '');
13 %$cust_main->set($pre.'state', $statedefault )
14 % unless $cust_main->get($pre.'state')
15 % || $cust_main->get($pre.'country') ne $countrydefault;
17 %#my($county_html, $state_html, $country_html) =
18 %# FS::cust_main_county::regionselector( $cust_main->get($pre.'county'),
19 %# $cust_main->get($pre.'state'),
20 %# $cust_main->get($pre.'country'),
27 % 'county' => $cust_main->get($pre.'county'),
28 % 'state' => $cust_main->get($pre.'state'),
29 % 'country' => $cust_main->get($pre.'country'),
31 % 'onchange' => $onchange,
32 % 'disabled' => $disabled,
35 %my $daytime_label = FS::Msgcat::_gettext('daytime') || 'Day Phone';
36 %my $night_label = FS::Msgcat::_gettext('night') || 'Night Phone';
38 %my $r = qq!<font color="#ff0000">*</font> !;
43 <% &ntable("#cccccc") %>
46 <TH ALIGN="right"><%$r%>Contact name<BR>(last, first)</TH>
48 <INPUT TYPE="text" NAME="<%$pre%>last" VALUE="<% $cust_main->get($pre.'last') %>" onChange="<% $onchange %>" <%$disabled%>> ,
49 <INPUT TYPE="text" NAME="<%$pre%>first" VALUE="<% $cust_main->get($pre.'first') %>" onChange="<% $onchange %>" <%$disabled%>>
51 % if ( $conf->exists('show_ss') && !$pre ) {
53 <TD ALIGN="right">SS#</TD>
54 <TD><INPUT TYPE="text" NAME="ss" VALUE="<% $cust_main->ss %>" SIZE=11></TD>
57 <TD><INPUT TYPE="hidden" NAME="ss" VALUE="<% $cust_main->ss %>"></TD>
64 <TD ALIGN="right">Company</TD>
66 <INPUT TYPE="text" NAME="<%$pre%>company" VALUE="<% $cust_main->get($pre.'company') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
71 <TH ALIGN="right"><%$r%>Address</TH>
73 <INPUT TYPE="text" NAME="<%$pre%>address1" VALUE="<% $cust_main->get($pre.'address1') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
78 <TD ALIGN="right"> </TD>
80 <INPUT TYPE="text" NAME="<%$pre%>address2" VALUE="<% $cust_main->get($pre.'address2') %>" SIZE=70 onChange="<% $onchange %>" <%$disabled%>>
85 <TH ALIGN="right"><%$r%>City</TH>
87 <INPUT TYPE="text" NAME="<%$pre%>city" VALUE="<% $cust_main->get($pre.'city') %>" onChange="<% $onchange %>" <%$disabled%>>
89 <TH ALIGN="right"><%$r%>State</TH>
91 <% include('select-county.html', %select_hash ) %>
92 <% include('select-state.html', %select_hash ) %>
96 <INPUT TYPE="text" NAME="<%$pre%>zip" VALUE="<% $cust_main->get($pre.'zip') %>" SIZE=10 onChange="<% $onchange %>" <%$disabled%>>
101 <TH ALIGN="right"><%$r%>Country</TH>
102 <TD COLSPAN=5><% include('select-country.html', %select_hash ) %></TD>
106 <TD ALIGN="right"><% $daytime_label %></TD>
108 <INPUT TYPE="text" NAME="<%$pre%>daytime" VALUE="<% $cust_main->get($pre.'daytime') %>" SIZE=18 onChange="<% $onchange %>" <%$disabled%>>
113 <TD ALIGN="right"><% $night_label %></TD>
115 <INPUT TYPE="text" NAME="<%$pre%>night" VALUE="<% $cust_main->get($pre.'night') %>" SIZE=18 onChange="<% $onchange %>" <%$disabled%>>
120 <TD ALIGN="right">Fax</TD>
122 <INPUT TYPE="text" NAME="<%$pre%>fax" VALUE="<% $cust_main->get($pre.'fax') %>" SIZE=12 onChange="<% $onchange %>" <%$disabled%>>
127 <%$r%>required fields<BR>