fs_selfservice/FS-SelfService/cgi/recharge_prepay.html

   1 <%= $url = "$selfurl?session=$session_id;action="; ''; %>
   2 <%= include('header') %>
   3
   4 <FONT SIZE=4>Recharge with prepaid card</FONT><BR><BR>
   5 <FORM NAME="OneTrueForm" METHOD="POST" ACTION="<%=$selfurl%>" onSubmit="document.OneTrueForm.process.disabled=true">
   6 <INPUT TYPE="hidden" NAME="session" VALUE="<%=$session_id%>">
   7 <INPUT TYPE="hidden" NAME="action" VALUE="recharge_results">
   8 <TABLE BGCOLOR="#cccccc">
   9 <!--
  10 <TR>
  11   <TD ALIGN="right">Amount&nbsp;Due</TD>
  12   <TD>
  13     <TABLE><TR><TD BGCOLOR="#ffffff">
  14       $<%=sprintf("%.2f",$balance)%>
  15     </TD></TR></TABLE>
  16   </TD>
  17 </TR>
  18 -->
  19 <TR>
  20   <TD ALIGN="right">Prepaid&nbsp;card&nbsp;number</TD>
  21   <TD>
  22     <INPUT TYPE="text" NAME="prepaid_cardnum" SIZE=20 MAXLENGTH=19 VALUE="<%=$prepaid_cardnum%>">
  23   </TD>
  24 </TR>
  25 </TABLE>
  26 <BR>
  27 <INPUT TYPE="hidden" NAME="paybatch" VALUE="<%=$paybatch%>">
  28 <INPUT TYPE="submit" NAME="process" VALUE="Recharge"> <!-- onClick="this.disabled=true"> -->
  29 </FORM>
  30
  31 <%= include('footer') %>