<HTML><HEAD><TITLE>ISP Signup form</TITLE></HEAD>
-<BODY BGCOLOR="#e8e8e8"><FONT SIZE=7>ISP Signup form</FONT><BR><BR>
+<BODY BGCOLOR="#e8e8e8" onUnload="myclose()">
+<script language="JavaScript"><!--
+ var mywindow = -1;
+ function myopen(filename,windowname,properties) {
+ myclose();
+ mywindow = window.open(filename,windowname,properties);
+ }
+ function myclose() {
+ if ( mywindow != -1 )
+ mywindow.close();
+ mywindow = -1
+ }
+//--></script>
+<FONT SIZE=7>ISP Signup form</FONT><BR><BR>
<FONT SIZE="+1" COLOR="#ff0000"><%= $error %></FONT>
-<FORM ACTION="<%= $self_url %>" METHOD=POST>
+<FORM NAME="OneTrueForm" ACTION="<%= $self_url %>" METHOD=POST onSubmit="document.OneTrueForm.signup.disabled=true">
<INPUT TYPE="hidden" NAME="magic" VALUE="process">
<INPUT TYPE="hidden" NAME="ref" VALUE="<%= $referral_custnum %>">
<INPUT TYPE="hidden" NAME="ss" VALUE="">
+Where did you hear about our service? <SELECT NAME="refnum">
+<%=
+ $OUT .= '<OPTION VALUE="">' unless $refnum;
+ foreach my $part_referral ( @{$init_data->{'part_referral'}} ) {
+ $OUT .= '<OPTION VALUE="'. $part_referral->{'refnum'}. '"';
+ $OUT .= ' SELECTED' if $part_referral->{'refnum'} eq $refnum;
+ $OUT .= '>'. $part_referral->{'referral'};
+ }
+%>
+</SELECT><BR><BR>
Contact Information
<TABLE BGCOLOR="#c0c0c0" BORDER=0 CELLSPACING=0 WIDTH="100%">
<TR>
<TH ALIGN="right"><font color="#ff0000">*</font>City</TH>
<TD><INPUT TYPE="text" NAME="city" VALUE="<%= $city %>"></TD>
<TH ALIGN="right"><font color="#ff0000">*</font>State/Country</TH>
- <TD><SELECT NAME="state" SIZE="1">
-
- <%=
- foreach ( @{$locales} ) {
- $OUT .= '<OPTION';
- $OUT .= ' SELECTED' if ( $state eq $_->{'state'}
- && $county eq $_->{'county'}
- && $country eq $_->{'country'}
- );
- $OUT .= '>'. $_->{'state'};
- $OUT .= ' ('. $_->{'county'}. ')' if $_->{'county'};
- $OUT .= ' / '. $_->{'country'};
- }
- %>
-
- </SELECT></TD>
+ <TD>
+ <%=
+ ($county_html, $state_html, $country_html) =
+ regionselector( $county, $state, $country );
+
+ "$county_html $state_html";
+ %>
+ </TD>
<TH><font color="#ff0000">*</font>Zip</TH>
<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>
+<TR>
<TD ALIGN="right">Day Phone</TD>
<TD COLSPAN=5><INPUT TYPE="text" NAME="daytime" VALUE="<%= $daytime %>" SIZE=18></TD>
</TR>
</TD></TR>
<TR><TD>Email invoice <INPUT TYPE="text" NAME="invoicing_list" VALUE="<%= join(', ', grep { $_ ne 'POST' } split(', ', $invoicing_list ) ) %>">
</TD></TR>
-<TR><TD>Billing type</TD></TR></TABLE>
+<%= scalar(@payby) > 1 ? '<TR><TD>Billing type</TD></TR>' : '' %>
+</TABLE>
<TABLE BGCOLOR="#c0c0c0" BORDER=1 WIDTH="100%">
<TR>
<%=
+
+ my $cardselect = '<SELECT NAME="CARD_type"><OPTION></OPTION>';
+ my %types = (
+ 'VISA' => 'VISA card',
+ 'MasterCard' => 'MasterCard',
+ 'Discover' => 'Discover card',
+ 'American Express' => 'American Express card',
+ );
+ foreach ( keys %types ) {
+ $selected = $cgi->param('CARD_type') eq $types{$_} ? 'SELECTED' : '';
+ $cardselect .= qq!<OPTION $selected VALUE="$types{$_}">$_</OPTION>!;
+ }
+ $cardselect .= '</SELECT>';
+
my %payby = (
- 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="CARD_payinfo" VALUE="" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD"). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="">!,
+ 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="CARD_payinfo" VALUE="" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD"). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="">!,
+ 'DCRD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="DCRD_payinfo" VALUE="" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("DCRD"). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="DCRD_payname" VALUE="">!,
+ 'CHEK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="CHEK_payinfo1" VALUE="" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="CHEK_payinfo2" VALUE="" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="CHEK_month" VALUE="12"><INPUT TYPE="hidden" NAME="CHEK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="CHEK_payname" VALUE="">!,
+ 'DCHK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="DCHK_payinfo1" VALUE="" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="DCHK_payinfo2" VALUE="" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="DCHK_month" VALUE="12"><INPUT TYPE="hidden" NAME="DCHK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="DCHK_payname" VALUE="">!,
+ 'LECB' => qq!Phone bill billing<BR>${r}Phone number <INPUT TYPE="text" BANE="LECB_payinfo" VALUE="" MAXLENGTH=15 SIZE=16><INPUT TYPE="hidden" NAME="LECB_month" VALUE="12"><INPUT TYPE="hidden" NAME="LECB_year" VALUE="2037"><INPUT TYPE="hidden" NAME="LECB_payname" VALUE="">!,
'BILL' => qq!Billing<BR>P.O. <INPUT TYPE="text" NAME="BILL_payinfo" VALUE=""><BR><font color="#ff0000">*</font>Exp !. expselect("BILL", "12-2037"). qq!<BR><font color="#ff0000">*</font>Attention<BR><INPUT TYPE="text" NAME="BILL_payname" VALUE="Accounts Payable">!,
'COMP' => qq!Complimentary<BR><font color="#ff0000">*</font>Approved by<INPUT TYPE="text" NAME="COMP_payinfo" VALUE=""><BR><font color="#ff0000">*</font>Exp !. expselect("COMP"),
'PREPAY' => qq!Prepaid card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="PREPAY_payinfo" VALUE="" MAXLENGTH=80>!,
);
+ if ( $init_data->{'cvv_enabled'} ) {
+ foreach my $payby ( grep { exists $payby{$_} } qw(CARD DCRD) ) { #1.4/1.5
+ $payby{$payby} .= qq!<BR>CVV2 (<A HREF="javascript:myopen('cvv2.html','cvv2','toolbar=no,location=no,directories=no,status=no,menubar=no,scrollbars=no,resizable=yes,copyhistory=no,width=480,height=288')">help</A>) <INPUT TYPE="text" NAME=${payby}_paycvv VALUE="" SIZE=4 MAXLENGTH=4>!;
+ }
+ }
+
+ my( $account, $aba ) = split('@', $payinfo);
my %paybychecked = (
- 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="CARD_payinfo" VALUE="$payinfo" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD", $paydate). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="$payname">!,
+ 'CARD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="CARD_payinfo" VALUE="$payinfo" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("CARD", $paydate). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="CARD_payname" VALUE="$payname">!,
+ 'DCRD' => qq!Credit card<BR><font color="#ff0000">*</font>$cardselect<INPUT TYPE="text" NAME="DCRD_payinfo" VALUE="$payinfo" MAXLENGTH=19><BR><font color="#ff0000">*</font>Exp !. expselect("DCRD", $paydate). qq!<BR><font color="#ff0000">*</font>Name on card<BR><INPUT TYPE="text" NAME="DCRD_payname" VALUE="$payname">!,
+ 'CHEK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="CHEK_payinfo1" VALUE="$account" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="CHEK_payinfo2" VALUE="$aba" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="CHEK_month" VALUE="12"><INPUT TYPE="hidden" NAME="CHEK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="CHEK_payname" VALUE="$payname">!,
+ 'DCHK' => qq!Electronic check<BR>${r}Account number <INPUT TYPE="text" NAME="DCHK_payinfo1" VALUE="$account" MAXLENGTH=10><BR>${r}ABA/Routing code <INPUT TYPE="text" NAME="DCHK_payinfo2" VALUE="$aba" SIZE=10 MAXLENGTH=9><INPUT TYPE="hidden" NAME="DCHK_month" VALUE="12"><INPUT TYPE="hidden" NAME="DCHK_year" VALUE="2037"><BR>${r}Bank name <INPUT TYPE="text" NAME="DCHK_payname" VALUE="$payname">!,
+ 'LECB' => qq!Phone bill billing<BR>${r}Phone number <INPUT TYPE="text" BANE="LECB_payinfo" VALUE="$payinfo" MAXLENGTH=15 SIZE=16><INPUT TYPE="hidden" NAME="LECB_month" VALUE="12"><INPUT TYPE="hidden" NAME="LECB_year" VALUE="2037"><INPUT TYPE="hidden" NAME="LECB_payname" VALUE="">!,
'BILL' => qq!Billing<BR>P.O. <INPUT TYPE="text" NAME="BILL_payinfo" VALUE="$payinfo"><BR><font color="#ff0000">*</font>Exp !. expselect("BILL", $paydate). qq!<BR><font color="#ff0000">*</font>Attention<BR><INPUT TYPE="text" NAME="BILL_payname" VALUE="$payname">!,
'COMP' => qq!Complimentary<BR><font color="#ff0000">*</font>Approved by<INPUT TYPE="text" NAME="COMP_payinfo" VALUE="$payinfo"><BR><font color="#ff0000">*</font>Exp !. expselect("COMP", $paydate),
'PREPAY' => qq!Prepaid card<BR><font color="#ff0000">*</font><INPUT TYPE="text" NAME="PREPAY_payinfo" VALUE="$payinfo" MAXLENGTH=80>!,
);
+ if ( $init_data->{'cvv_enabled'} ) {
+ foreach my $payby ( grep { exists $payby{$_} } qw(CARD DCRD) ) { #1.4/1.5
+ $paybychecked{$payby} .= qq!<BR>CVV2 (<A HREF="javascript:myopen('cvv2.html','cvv2','toolbar=no,location=no,directories=no,status=no,menubar=no,scrollbars=no,resizable=yes,copyhistory=no,width=480,height=288')">help</A>) <INPUT TYPE="text" NAME=${payby}_paycvv VALUE="$paycvv" SIZE=4 MAXLENGTH=4>!;
+ }
+ }
+
for (@payby) {
- $OUT .= qq!<TD VALIGN=TOP><INPUT TYPE="radio" NAME="payby" VALUE="$_"!;
- if ($payby eq $_) {
- $OUT .= qq! CHECKED> $paybychecked{$_}</TD>!;
+ if ( scalar(@payby) == 1) {
+ $OUT .= '<TD VALIGN=TOP>'.
+ qq!<INPUT TYPE="hidden" NAME="payby" VALUE="$_">!.
+ "$paybychecked{$_}</TD>";
} else {
- $OUT .= qq!> $payby{$_}</TD>!;
+ $OUT .= qq!<TD VALIGN=TOP><INPUT TYPE="radio" NAME="payby" VALUE="$_"!;
+ if ($payby eq $_) {
+ $OUT .= qq! CHECKED> $paybychecked{$_}</TD>!;
+ } else {
+ $OUT .= qq!> $payby{$_}</TD>!;
+ }
+
}
}
%>
</TR>
<TR>
<TD ALIGN="right">Password</TD>
- <TD><INPUT TYPE="text" NAME="_password" VALUE="<%= $password %>">
- (blank to generate)</TD>
+ <TD><INPUT TYPE="password" NAME="_password" VALUE="<%= $password %>"></TD>
</TR>
<TR>
<TD ALIGN="right">Re-enter Password</TD>
- <TD><INPUT TYPE="password" NAME="_password2" VALUE="<%= $password2 %>">
- </TD>
+ <TD><INPUT TYPE="password" NAME="_password2" VALUE="<%= $password2 %>"></TD>
</TR>
<%=
if ( $init_data->{'security_phrase'} ) {
$OUT .= '<INPUT TYPE="hidden" NAME="sec_phrase" VALUE="">';
}
%>
-<TR>
- <TD ALIGN="right">Access number</TD>
- <TD><%= popselector($popnum) %></TD>
-</TR>
+<%=
+ if ( scalar(@$pops) ) {
+ $OUT .= '<TR><TD ALIGN="right">Access number</TD><TD>'.
+ popselector($popnum). '</TD></TR>';
+ } else {
+ $OUT .= popselector($popnum);
+ }
+%>
</TABLE>
-<BR><BR><INPUT TYPE="submit" VALUE="Signup">
+<BR><BR><INPUT TYPE="submit" NAME="signup" VALUE="Signup">
</FORM></BODY></HTML>
projects / freeside.git / blobdiff