<%= include('header', 'Make a payment') %>

<%= $tr_amount_fee %> <%= include('discount_term') %> <%= include('card') %>

Amount Due	$<%=sprintf("%.2f",$balance)%>
Card type	<%= foreach ( keys %card_types ) { $selected = $card_type eq $card_types{$_} ? ' SELECTED' : ''; $OUT .= qq($_\n); } %>
NAME="save" VALUE="1"> Remember this card and billing address
NAME="auto" VALUE="1" onClick="if (this.checked) { document.OneTrueForm.save.checked=true; }"> Charge future payments to this card automatically

<%= include('footer') %>