MyAccount
<%= $url = "$selfurl?session=$session_id;action="; ''; %> <%= include('myaccount_menu') %>
Make a payment
Amount Due
$<%=sprintf("%.2f",$balance)%>
Payment amount
$
">
Card type
<%= foreach ( keys %card_types ) { $selected = $card_type eq $card_types{$_} ? ' SELECTED' : ''; $OUT .= qq(
$_\n); } %>
Card number
Exp.
<%= for ( ( map "0$_", 1 .. 9 ), 10 .. 12 ) { $OUT .= '
$_\n"; } %>
/
<%= my @a = localtime; for ( $a[5]+1900 .. $a[5]+1915 ) { $OUT .= '
$_\n"; } %>
CVV2 (
help
)
Exact name on card
Card billing address
Address line 2
City
State
<%= for ( @states ) { $OUT .= '
$_\n"; } %>
Zip
Remember this information
NAME="auto" VALUE="1" onClick="if (this.checked) { document.OneTrueForm.save.checked=true; }"> Charge future payments to this card automatically
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freeside