<FONT SIZE="+1" COLOR="#ff0000"><%= $error %></FONT>
<FORM NAME="OneTrueForm" ACTION="<%= $self_url %>" METHOD=POST onSubmit="document.OneTrueForm.signup.disabled=true">
+<INPUT TYPE="hidden" NAME="prepaid_shortform" VALUE="<%= $prepaid_shortform %>">
<INPUT TYPE="hidden" NAME="session" VALUE="<%= $session_id %>">
<INPUT TYPE="hidden" NAME="action" VALUE="process_signup">
+<INPUT TYPE="hidden" NAME="agentnum" VALUE="<%= $agentnum %>">
<INPUT TYPE="hidden" NAME="referral_custnum" VALUE="<%= $referral_custnum %>">
<INPUT TYPE="hidden" NAME="ss" VALUE="">
<input type="hidden" name="payby">
%>
<%=
- $OUT = join("\n", map { qq|<input type="hidden" name="$_" />| } qw / promo_code reg_code pkgpart username _password _password2 sec_phrase popnum countrycode phonenum sip_password pin / );
+ $OUT = join("\n", map { qq|<input type="hidden" name="$_" />| } qw / promo_code reg_code pkgpart username _password _password2 sec_phrase popnum mac_addr countrycode phonenum sip_password pin / );
%>
Where did you hear about our service? <SELECT NAME="refnum">
$OUT .= '<OPTION VALUE="">' unless $refnum;
foreach my $part_referral ( @part_referral ) {
$OUT .= '<OPTION VALUE="'. $part_referral->{'refnum'}. '"';
- $OUT .= ' SELECTED' if $part_referral->{'refnum'} eq $refnum;
+ $OUT .= ' SELECTED' if $part_referral->{'refnum'} == $refnum;
$OUT .= '>'. $part_referral->{'referral'};
}
%>
</SELECT><BR><BR>
+
+<%= unless ( $prepaid_template_custnum && $prepaid_shortform ) {
+
+my $bgcolor = $box_bgcolor || '#c0c0c0';
+$OUT .= qq!
Contact Information
-<TABLE BGCOLOR="<%= $box_bgcolor || '#c0c0c0' %>" BORDER=0 CELLSPACING=0 WIDTH="100%">
+<TABLE BGCOLOR="$bgcolor" BORDER=0 CELLSPACING=0 WIDTH="100%">
<TR>
<TH ALIGN="right"><font color="#ff0000">*</font>Contact name<BR>(last, first)</TH>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="last" VALUE="<%= $last %>">,
- <INPUT TYPE="text" NAME="first" VALUE="<%= $first %>"></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="last" VALUE="$last">,
+ <INPUT TYPE="text" NAME="first" VALUE="$first"></TD>
</TR>
<TR>
<TD ALIGN="right">Company</TD>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="company" SIZE=70 VALUE="<%= $company %>"></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="company" SIZE=70 VALUE="$company"></TD>
</TR>
<TR>
<TH ALIGN="right"><font color="#ff0000">*</font>Address</TH>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="address1" SIZE=70 VALUE="<%= $address1 %>"></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="address1" SIZE=70 VALUE="$address1"></TD>
</TR>
<TR>
<TD ALIGN="right"> </TD>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="address2" SIZE=70 VALUE="<%= $address2 %>"></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="address2" SIZE=70 VALUE="$address2"></TD>
</TR>
<TR>
<TH ALIGN="right"><font color="#ff0000">*</font>City</TH>
- <TD><INPUT TYPE="text" NAME="city" VALUE="<%= $city %>"></TD>
- <TH ALIGN="right"><font color="#ff0000">*</font>State/Country</TH>
- <TD>
- <%=
- ($county_html, $state_html, $country_html) =
+ <TD><INPUT TYPE="text" NAME="city" VALUE="$city"></TD> !;
+
+ my ($county_html, $state_html, $country_html) =
regionselector( {
selected_county => $county,
selected_state => $state,
locales => \@cust_main_county,
} );
- "$county_html $state_html";
- %>
+$county_out = ($county_html =~ /SELECT/) ? 'County/State' : 'State';
+$OUT .= qq!<TH ALIGN="right"><font color="#ff0000">*</font> $county_out </TH>
+ <TD>
+ $county_html $state_html
</TD>
<TH><font color="#ff0000">*</font>Zip</TH>
- <TD><INPUT TYPE="text" NAME="zip" SIZE=10 VALUE="<%= $zip %>"></TD>
+ <TD><INPUT TYPE="text" NAME="zip" SIZE=10 VALUE="$zip"></TD>
</TR>
<TR>
<TH ALIGN="right"><font color="#ff0000">*</font>Country</TH>
- <TD><%= $country_html %></TD>
+ <TD>$country_html</TD>
<TR>
<TD ALIGN="right">Day Phone</TD>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="daytime" VALUE="<%= $daytime %>" SIZE=18></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="daytime" VALUE="$daytime" SIZE=18></TD>
</TR>
<TR>
<TD ALIGN="right">Night Phone</TD>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="night" VALUE="<%= $night %>" SIZE=18></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="night" VALUE="$night" SIZE=18></TD>
</TR>
<TR>
<TD ALIGN="right">Fax</TD>
- <TD COLSPAN=5><INPUT TYPE="text" NAME="fax" VALUE="<%= $fax %>" SIZE=12></TD>
+ <TD COLSPAN=5><INPUT TYPE="text" NAME="fax" VALUE="$fax" SIZE=12></TD>
</TR>
-<%=
- $OUT = '';
+!;
if ( $stateid_enabled ) {
my ($county_html, $state_html, $country_html) =
regionselector( {
$OUT .= qq!<TD ALIGN="right">!. $label{stateid_state} .'</TD>';
$OUT .="<TD COLSPAN=3>$county_html $state_html</TD></TR>";
}
-%>
+$OUT .= qq!
</TABLE><font color="#ff0000">*</font> required fields<BR>
+!;
+
+}
+else {
+ @payby = ('PREPAY');
+}
+%>
+
<BR>Billing information<TABLE BGCOLOR="<%= $box_bgcolor || '#c0c0c0' %>" BORDER=0 CELLSPACING=0 WIDTH="100%">
<TR><TD>
}
}
-use Tie::IxHash;
-use HTML::Widgets::SelectLayers;
-
my %payby_index = ( 'CARD' => qq/Credit Card/,
'DCRD' => qq/Credit Card/,
'CHEK' => qq/Check/,
form_name => 'dummy',
html_between => '</td></tr></table>',
form_action => 'dummy.cgi',
- layer_callback => sub { my $layer = shift; return $paybychecked{$layer}. '</TABLE>'; },
+ layer_callback => sub { my $layer = shift; return ( shift @hide_payment_fields ? '' : $paybychecked{$layer} ) . '</TABLE>'; },
)->html;
$OUT .= '<INPUT TYPE="hidden" NAME="sec_phrase" VALUE="">';
}
+ if ( $nomadix ) {
+
+ warn $mac_addr;
+ $mac_addr ||= $MA;
+ warn $mac_addr;
+
+ $OUT .= <<NOMADIX;
+ <INPUT TYPE="hidden" NAME="mac_addr" VALUE="$mac_addr">
+NOMADIX
+
+ }
+
}
if ( @svc_acct_pop ) {
var signup_elements = new Array (
'promo_code', 'reg_code', 'pkgpart',
'username', '_password', '_password2', 'sec_phrase', 'popnum',
+ 'mac_addr',
'countrycode', 'phonenum', 'sip_password', 'pin'
);