X-Git-Url: http://git.freeside.biz/gitweb/?a=blobdiff_plain;f=fs_selfservice%2FFS-SelfService%2Fcgi%2Fmake_payment.html;h=5f5bc1c8e50773527292d6ce40952c84b663cde9;hb=c51bb6288f574d5b71424880c2bae262564de8a5;hp=cf6d62e22bd3544e9241b9a5cbf1dcea4fdedbcc;hpb=0b227319d33d012890891570891f9d9401ff89ff;p=freeside.git diff --git a/fs_selfservice/FS-SelfService/cgi/make_payment.html b/fs_selfservice/FS-SelfService/cgi/make_payment.html index cf6d62e22..5f5bc1c8e 100644 --- a/fs_selfservice/FS-SelfService/cgi/make_payment.html +++ b/fs_selfservice/FS-SelfService/cgi/make_payment.html @@ -1,33 +1,24 @@ -MyAccount -MyAccount

-<%= $url = "$selfurl?session=$session_id;action="; ''; %> -
-MyAccount
- -		 -Make a payment

+<%= include('header', 'Make a payment') %> +
- - - + + +<%= $tr_amount_fee %> + +<%= include('discount_term') %> + - - - - - + - - - - - - - - - - - - - - - - - +<%= include('card') %> + + -
Amount Due + Amount Due
- $<%=sprintf("%.2f",$balance)%> + $<%=sprintf("%.2f",$balance)%>
Payment amount -
- $"> -
-
Card type + Card type
Card number - - - - - - - - -
- Exp. - - / - -
-
Exact name on card
Card billing address - -
Address line 2 - -
City - - - - - - - - -
- - State - - Zip - -
-
- - Remember this information +
+ 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

- +
-
-
-powered by freeside - +<%= include('footer') %>