X-Git-Url: http://git.freeside.biz/gitweb/?a=blobdiff_plain;f=fs_selfservice%2FFS-SelfService%2Fcgi%2Fmake_payment.html;h=915714cc352ee0a8505647500ddab41bfa8005f7;hb=8cc50a2ad12ec3d5bd3f31db741290664064ef06;hp=d469bddb61da3d345ddbc991281a7f2133c77e77;hpb=2c88b03550a72438bbd75ec7461d2c26fc797efc;p=freeside.git diff --git a/fs_selfservice/FS-SelfService/cgi/make_payment.html b/fs_selfservice/FS-SelfService/cgi/make_payment.html index d469bddb6..915714cc3 100644 --- a/fs_selfservice/FS-SelfService/cgi/make_payment.html +++ b/fs_selfservice/FS-SelfService/cgi/make_payment.html @@ -1,118 +1,48 @@ -MyAccount -MyAccount

-<%= $url = "$selfurl?session=$session_id;action="; ''; %> -
-MyAccount
- -		 -Make a payment

-
- - +<%= include('header', 'Make a payment') %> + + + - - + + +<%= $tr_amount_fee %> + +<%= include('discount_term') %> + - - - - - + - - - - - - - - - - - - - - - - - +<%= include('card') %> + + -
Amount Due + Amount Due
- $<%=sprintf("%.2f",$balance)%> + $<%=sprintf("%.2f",$balance)%>
Payment amount -
- $"> -
-
Card type + Card type
Card number - - - - - - - - -
- Exp. - - / - -
-
Exact name on card
Card billing address - -
Address line 2 - -
City - - - - - - - - -
- - State - - Zip - -
-
- - Remember this information +
+ NAME="save" VALUE="1"> + Remember this card and billing address
- NAME="CARD"> + + NAME="auto" VALUE="1" onClick="if (this.checked) { document.OneTrueForm.save.checked=true; }"> Charge future payments to this card automatically
- +
+ +
-
-
-powered by freeside - +<%= include('footer') %>