'</FONT><BR><BR>';
} ''; %>
<FORM ACTION="<%= $selfurl %>" METHOD=POST>
-<INPUT TYPE="hidden" NAME="session" VALUE="<%= $session_id %>">
<INPUT TYPE="hidden" NAME="action" VALUE="process_svc_acct">
<INPUT TYPE="hidden" NAME="custnum" VALUE="<%= $custnum %>">
<INPUT TYPE="hidden" NAME="pkgnum" VALUE="<%= $pkgnum %>">
<TD ALIGN="right">Username</TD>
<TD><INPUT TYPE="text" NAME="username" VALUE="<%= $username %>"></TD>
</TR>
+<%=
+ $OUT .= domainselector(pkgnum=>$pkgnum, svcpart=>$svcpart);
+%>
<TR>
<TD ALIGN="right">Password</TD>
<TD><INPUT TYPE="password" NAME="_password" VALUE="<%= $_password %>"></TD>