This commit was generated by cvs2svn to compensate for changes in r8690,
[freeside.git] / fs_selfservice / FS-SelfService / cgi / change_bill.html
1 <%= $url = "$selfurl?session=$session_id;action="; ''; %>
2 <%= include('header') %>
3
4 <FONT SIZE=4>Edit billing address</FONT><BR><BR>
5 <%= if ( $error ) { 
6   $OUT .= qq!<FONT SIZE="+1" COLOR="#ff0000">Error: $error</FONT><BR><BR>!;
7 }  ''; %>
8
9 <FORM NAME="ChangeBillForm" ACTION="<%= $selfurl %>" METHOD=POST onSubmit="document.bottomform.submit.disabled=true;">
10 <INPUT TYPE="hidden" NAME="session" VALUE="<%= $session_id %>">
11 <INPUT TYPE="hidden" NAME="action" VALUE="process_change_bill">
12 <TABLE BGCOLOR="#cccccc" BORDER=0 CELLSPACING=0>
13
14 <%= $r=qq!<font color="#ff0000">*</font>&nbsp;!; include('contact') %>
15
16 <INPUT TYPE="submit" NAME="submit" VALUE="<%= $custnum ?  "Apply Changes" : "Add Customer" %>">
17 <BR>
18 </FORM>
19
20 <%= include('footer') %>