| <%=$r%>Contact name (last, first) |
> , > | ||||||
|---|---|---|---|---|---|---|---|
| Company | > | ||||||
| <%=$r%>Address | > | ||||||
| <%= my $style = ( $disabled || !$require_address2 || ( !$pre && $ship_last ) ) ? 'visibility:hidden' : ''; $OUT .= qq!* Unit #!; %> | > | ||||||
| <%=$r%>City | > | <%= ($county_html, $state_html, $country_html) = FS::SelfService::regionselector( { prefix => $pre, selected_county => ${$pre.'county'}, selected_state => ${$pre.'state'}, selected_country => ${$pre.'country'}, default_state => $statedefault, default_country => $countrydefault, locales => \@cust_main_county, } ); $OUT .= qq!${r}State/County | !; $OUT .= qq!$county_html $state_html | !; $OUT .= qq!${r}Zip | !; $OUT .= qq!!; $OUT .= qq! | ||
| ${r}Country | !; $OUT .= qq!$country_html | !; %>||||||
| Day Phone | > | ||||||
| Night Phone | > | ||||||
| Fax | > | ||||||