3 my( $cust_main, $pre, $onchange, $disabled ) = @_;
4 my $conf = new FS::Conf;
6 #false laziness with ship state
7 my $countrydefault = $conf->config('countrydefault') || 'US';
8 $cust_main->set($pre.'country', $countrydefault )
9 unless $cust_main->get($pre.'country');
11 my $statedefault = $conf->config('statedefault')
12 || ($countrydefault eq 'US' ? 'CA' : '');
13 $cust_main->set($pre.'state', $statedefault )
14 unless $cust_main->get($pre.'state')
15 || $cust_main->get($pre.'country') ne $countrydefault;
17 my($county_html, $state_html, $country_html) =
18 FS::cust_main_county::regionselector( $cust_main->get($pre.'county'),
19 $cust_main->get($pre.'state'),
20 $cust_main->get($pre.'country'),
26 my $daytime_label = FS::Msgcat::_gettext('daytime') || 'Day Phone';
27 my $night_label = FS::Msgcat::_gettext('night') || 'Night Phone';
29 my $r = qq!<font color="#ff0000">*</font> !;
33 <%= &ntable("#cccccc") %>
36 <TH ALIGN="right"><%=$r%>Contact name<BR>(last, first)</TH>
38 <INPUT TYPE="text" NAME="<%=$pre%>last" VALUE="<%= $cust_main->get($pre.'last') %>" onChange="<%= $onchange %>" <%=$disabled%>> ,
39 <INPUT TYPE="text" NAME="<%=$pre%>first" VALUE="<%= $cust_main->get($pre.'first') %>" onChange="<%= $onchange %>" <%=$disabled%>>
42 <% if ( $conf->exists('show_ss') && !$pre ) { %>
43 <TD ALIGN="right">SS#</TD>
44 <TD><INPUT TYPE="text" NAME="ss" VALUE="<%= $cust_main->ss %>" SIZE=11></TD>
45 <% } elsif ( !$pre ) { %>
46 <TD><INPUT TYPE="hidden" NAME="ss" VALUE="<%= $cust_main->ss %>"></TD>
52 <TD ALIGN="right">Company</TD>
54 <INPUT TYPE="text" NAME="<%=$pre%>company" VALUE="<%= $cust_main->get($pre.'company') %>" SIZE=70 onChange="<%= $onchange %>" <%=$disabled%>>
59 <TH ALIGN="right"><%=$r%>Address</TH>
61 <INPUT TYPE="text" NAME="<%=$pre%>address1" VALUE="<%= $cust_main->get($pre.'address1') %>" SIZE=70 onChange="<%= $onchange %>" <%=$disabled%>>
66 <TD ALIGN="right"> </TD>
68 <INPUT TYPE="text" NAME="<%=$pre%>address2" VALUE="<%= $cust_main->get($pre.'address2') %>" SIZE=70 onChange="<%= $onchange %>" <%=$disabled%>>
73 <TH ALIGN="right"><%=$r%>City</TH>
75 <INPUT TYPE="text" NAME="<%=$pre%>city" VALUE="<%= $cust_main->get($pre.'city') %>" onChange="<%= $onchange %>" <%=$disabled%>>
77 <TH ALIGN="right"><%=$r%>State</TH>
78 <TD><%= $county_html. $state_html %></TD>
81 <INPUT TYPE="text" NAME="<%=$pre%>zip" VALUE="<%= $cust_main->get($pre.'zip') %>" SIZE=10 onChange="<%= $onchange %>" <%=$disabled%>>
86 <TH ALIGN="right"><%=$r%>Country</TH>
87 <TD><%= $country_html %></TD>
91 <TD ALIGN="right"><%= $daytime_label %></TD>
93 <INPUT TYPE="text" NAME="<%=$pre%>daytime" VALUE="<%= $cust_main->get($pre.'daytime') %>" SIZE=18 onChange="<%= $onchange %>" <%=$disabled%>>
98 <TD ALIGN="right"><%= $night_label %></TD>
100 <INPUT TYPE="text" NAME="<%=$pre%>night" VALUE="<%= $cust_main->get($pre.'night') %>" SIZE=18 onChange="<%= $onchange %>" <%=$disabled%>>
105 <TD ALIGN="right">Fax</TD>
107 <INPUT TYPE="text" NAME="<%=$pre%>fax" VALUE="<%= $cust_main->get($pre.'fax') %>" SIZE=12 onChange="<%= $onchange %>" <%=$disabled%>>
112 <%=$r%>required fields<BR>