mirror of
https://github.com/mozilla/gecko-dev.git
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1232 lines
28 KiB
HTML
1232 lines
28 KiB
HTML
<html>
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<body bgcolor="white" text="black" link="#000099" vlink="#006699"
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alink="#000099">
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<table width="596" cellspacing="2" cellpadding="2" border="0">
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<tr>
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<td width="436" valign="TOP">
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<form>
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<input type="hidden" id="SID" name="SID" value=
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"209517917069809"><input type="hidden" id="MT" name=
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"MT" value="85">
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<table width="439" cellpadding="0" cellspacing="2"
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border="0">
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<tr>
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<td align="left" valign="bottom" colspan="2"><b>
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<font size="3">Your
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Billing Address</font></b></td>
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</tr>
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<tr><td></td></tr><tr><td></td></tr><tr><td></td></tr><tr><td></td></tr>
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<tr>
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<td>
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Your First Name:</td>
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<td><input name="bill.first" size="15" maxlength=
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"15" type="text" value="jack"> </td>
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</tr>
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<tr>
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<td>Your Last Name:</td>
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<td><input name="bill.last" size="30" maxlength=
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"30" type="text" value="smith"> </td>
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</tr>
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<tr>
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<td><nobr>Street Address Line 1:</nobr> </td>
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<td><input name="bill.street1" size="30" maxlength=
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"30" type="text" value=""> </td>
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</tr>
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<tr>
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<td><nobr>Street Address Line 2:</nobr> </td>
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<td><input name="bill.street2" size="30" maxlength=
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"30" type="text" value=""> </td>
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</tr>
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<tr>
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<td>City:</td>
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<td><input name="bill.city" size="30" maxlength=
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"30" type="text" value=""> </td>
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</tr>
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<tr>
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<td>State (U.S.):</td>
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<td><select name="bill.state" size="1">
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<option selected>
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Please Select a State
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<!-- Template Name: states.chk -->
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</option>
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<option value="AA">
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AA - Armed Forces Americas
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</option>
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<option value="AE">
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AE - Armed Forces Africa
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</option>
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<option value="AE">
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AE - Armed Forces Canada
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</option>
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<option value="AE">
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AE - Armed Forces Europe
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</option>
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<option value="AE">
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AE - Armed Forces Middle East
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</option>
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<option value="AP">
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AP - Armed Forces Pacific
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</option>
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<option value="AL">
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Alabama
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</option>
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<option value="AK">
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Alaska
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</option>
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<option value="AS">
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American Samoa
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</option>
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<option value="AZ">
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Arizona
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</option>
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<option value="AR">
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Arkansas
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</option>
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<option value="CA">
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California
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</option>
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<option value="CO">
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Colorado
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</option>
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<option value="CT">
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Connecticut
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</option>
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<option value="DE">
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Delaware
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</option>
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<option value="DC">
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District of Columbia
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</option>
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<option value="FL">
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Florida
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</option>
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<option value="GA">
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Georgia
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</option>
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<option value="GU">
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Guam
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</option>
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<option value="HI">
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Hawaii
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</option>
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<option value="ID">
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Idaho
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</option>
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<option value="IL">
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Illinois
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</option>
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<option value="IN">
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Indiana
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</option>
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<option value="IA">
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Iowa
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</option>
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<option value="KS">
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Kansas
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</option>
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<option value="KY">
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Kentucky
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</option>
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<option value="LA">
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Louisiana
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</option>
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<option value="ME">
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Maine
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</option>
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<option value="MD">
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Maryland
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</option>
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<option value="MA">
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Massachusetts
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</option>
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<option value="MI">
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Michigan
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</option>
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<option value="MN">
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Minnesota
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</option>
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<option value="MS">
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Mississippi
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</option>
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<option value="MO">
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Missouri
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</option>
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<option value="MT">
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Montana
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</option>
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<option value="NE">
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Nebraska
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</option>
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<option value="NV">
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Nevada
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</option>
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<option value="NH">
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New Hampshire
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</option>
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<option value="NJ">
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New Jersey
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</option>
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<option value="NM">
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New Mexico
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</option>
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<option value="NY">
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New York
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</option>
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<option value="NC">
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North Carolina
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</option>
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<option value="ND">
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North Dakota
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</option>
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<option value="MP">
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Northern Mariana Islands
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</option>
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<option value="OH">
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Ohio
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</option>
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<option value="OK">
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Oklahoma
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</option>
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<option value="OR">
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Oregon
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</option>
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<option value="PA">
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Pennsylvania
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</option>
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<option value="PR">
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Puerto Rico
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</option>
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<option value="RI">
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Rhode Island
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</option>
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<option value="SC">
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South Carolina
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</option>
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<option value="SD">
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South Dakota
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</option>
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<option value="TN">
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Tennessee
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</option>
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<option value="TX">
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Texas
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</option>
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<option value="TT">
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Trust Territory
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</option>
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<option value="UT">
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Utah
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</option>
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<option value="VT">
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Vermont
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</option>
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<option value="VA">
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Virginia
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</option>
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<option value="VI">
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Virgin Islands
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</option>
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<option value="WA">
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Washington
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</option>
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<option value="WV">
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West Virginia
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</option>
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<option value="WI">
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Wisconsin
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</option>
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<option value="WY">
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Wyoming
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</option>
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</select> </td>
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</tr>
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<tr>
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<td>Province (Int'l Only):</td>
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<td><input name="bill.province" value="" size="30"
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maxlength="30" type="text"> </td>
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</tr>
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<tr>
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<td><nobr>Zip/Postal Code:</nobr> </td>
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<td><input name="BillTo.PostalCode" value="" size="10"
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maxlength="10" type="text"></td>
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</tr>
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<tr>
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<td>Country:</td>
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<td><select name="bill.country">
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<option selected>
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UNITED STATES
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<!-- Template Name: countries.chk -->
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</option>
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<option>
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UNITED STATES
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</option>
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<option>
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ALBANIA
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</option>
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<option>
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ALGERIA
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</option>
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<option>
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ANDORRA
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</option>
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<option>
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ANGOLA
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</option>
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<option>
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ANGUILLA
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</option>
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<option>
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ANTIGUA
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</option>
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<option>
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ARGENTINA
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</option>
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<option>
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ARMENIA
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</option>
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<option>
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ARUBA
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</option>
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<option>
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AUSTRALIA
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</option>
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<option>
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AUSTRIA
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</option>
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<option>
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AZERBAIJAN
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</option>
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<option>
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AZORES
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</option>
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<option>
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BAHAMAS
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</option>
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<option>
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BAHRAIN
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</option>
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<option>
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BANGLADESH
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</option>
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<option>
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BARBADOS
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</option>
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<option>
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BARBUDA
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</option>
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<option>
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BELARUS
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</option>
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<option>
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BELGIUM
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</option>
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<option>
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BELIZE
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</option>
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<option>
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BENIN
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</option>
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<option>
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BERMUDA
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</option>
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<option>
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BHUTAN
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</option>
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<option>
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BOLIVIA
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</option>
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<option>
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BOSNIA-HERZEGOVINA
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</option>
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<option>
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BOTSWANA
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</option>
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<option>
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BRAZIL
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</option>
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<option>
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BRITISH VIRGIN ISL.
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</option>
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<option>
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BRUNEI DARUSSALAM
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</option>
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<option>
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BULGARIA
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</option>
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<option>
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BURKINA FASO
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</option>
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<option>
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BURMA
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</option>
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<option>
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BURUNDI
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</option>
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<option>
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CAMEROON
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</option>
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<option>
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CANADA
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</option>
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<option>
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CAPE VERDE
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</option>
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<option>
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CAYMAN ISLANDS
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</option>
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<option>
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CENTRAL AFRICAN REPUBLIC
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</option>
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<option>
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CHAD
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</option>
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<option>
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CHILE
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</option>
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<option>
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CHINA
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</option>
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<option>
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COLOMBIA
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</option>
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<option>
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COMOROS
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</option>
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<option>
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CONGO
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</option>
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<option>
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CORSICA
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</option>
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<option>
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COSTA RICA
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</option>
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<option>
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COTE d'IVOIRE (IVORY COAST)
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</option>
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<option>
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CROATIA
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</option>
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<option>
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CYPRUS
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</option>
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<option>
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CZECH REPUBLIC
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</option>
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<option>
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DENMARK
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</option>
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<option>
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DJIBOUTI
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</option>
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<option>
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DOMINICA
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</option>
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<option>
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DOMINICAN REPUBLIC
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</option>
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<option>
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ECUADOR
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</option>
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<option>
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EGYPT
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</option>
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<option>
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EL SALVADOR
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</option>
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<option>
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EQUATORIAL GUINEA
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</option>
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<option>
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|
ERITREA
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</option>
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<option>
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ESTONIA
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</option>
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<option>
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ETHIOPIA
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</option>
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<option>
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FAROE ISLANDS
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</option>
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<option>
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FIJI
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</option>
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<option>
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FINLAND
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</option>
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<option>
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FRANCE
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</option>
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<option>
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FRENCH GUIANA
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</option>
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<option>
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FRENCH POLYNESIA
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</option>
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<option>
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GABON
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</option>
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<option>
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GAMBIA
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</option>
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<option>
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|
GEORGIA, REPUBLIC OF
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</option>
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<option>
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GERMANY
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</option>
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<option>
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GHANA
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</option>
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<option>
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GIBRALTAR
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</option>
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<option>
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GREAT BRITAIN
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</option>
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<option>
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|
GREECE
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</option>
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<option>
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GREENLAND
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</option>
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<option>
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GRENADA
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</option>
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<option>
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GUADELOUPE
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</option>
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<option>
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GUATEMALA
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</option>
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<option>
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|
GUINEA
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</option>
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<option>
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|
GUINEA-BISSAU
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</option>
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<option>
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|
GUYANA
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</option>
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<option>
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|
HAITI
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</option>
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|
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<option>
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|
HONDURAS
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</option>
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|
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<option>
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|
HONG KONG
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</option>
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|
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|
<option>
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|
HUNGARY
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|
</option>
|
|
|
|
<option>
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|
ICELAND
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|
</option>
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|
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<option>
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|
INDIA
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|
</option>
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|
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<option>
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|
INDONESIA
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</option>
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<option>
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|
IRAN
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</option>
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<option>
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|
IRELAND (EIRE)
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</option>
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<option>
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ISRAEL
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</option>
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<option>
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ITALY
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</option>
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<option>
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|
JAMAICA
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</option>
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<option>
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|
JAPAN
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</option>
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<option>
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|
JORDAN
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</option>
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<option>
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KAZAKHSTAN
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</option>
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<option>
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KENYA
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</option>
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<option>
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KIRIBATI
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</option>
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<option>
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|
KOREA, DEM. PEOPLE'S REP. (North)
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</option>
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<option>
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|
KOREA, REPUBLIC OF
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</option>
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<option>
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|
KUWAIT
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</option>
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<option>
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KYRGYZSTAN
|
|
</option>
|
|
|
|
<option>
|
|
LAOS
|
|
</option>
|
|
|
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<option>
|
|
LATVIA
|
|
</option>
|
|
|
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<option>
|
|
LEBANON
|
|
</option>
|
|
|
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<option>
|
|
LESOTHO
|
|
</option>
|
|
|
|
<option>
|
|
LIBYA
|
|
</option>
|
|
|
|
<option>
|
|
LIECHTENSTEIN
|
|
</option>
|
|
|
|
<option>
|
|
LITHUANIA
|
|
</option>
|
|
|
|
<option>
|
|
LUXEMBOURG
|
|
</option>
|
|
|
|
<option>
|
|
MACAO
|
|
</option>
|
|
|
|
<option>
|
|
MACEDONIA, REPUBLIC OF
|
|
</option>
|
|
|
|
<option>
|
|
MADAGASCAR
|
|
</option>
|
|
|
|
<option>
|
|
MADEIRA ISLANDS
|
|
</option>
|
|
|
|
<option>
|
|
MALAWI
|
|
</option>
|
|
|
|
<option>
|
|
MALAYSIA
|
|
</option>
|
|
|
|
<option>
|
|
MALDIVES
|
|
</option>
|
|
|
|
<option>
|
|
MALI
|
|
</option>
|
|
|
|
<option>
|
|
MALTA
|
|
</option>
|
|
|
|
<option>
|
|
MARTINIQUE
|
|
</option>
|
|
|
|
<option>
|
|
MAURITANIA
|
|
</option>
|
|
|
|
<option>
|
|
MAURITIUS
|
|
</option>
|
|
|
|
<option>
|
|
MEXICO
|
|
</option>
|
|
|
|
<option>
|
|
MOLDOVA
|
|
</option>
|
|
|
|
<option>
|
|
MONACO
|
|
</option>
|
|
|
|
<option>
|
|
MONTSERRAT
|
|
</option>
|
|
|
|
<option>
|
|
MOROCCO
|
|
</option>
|
|
|
|
<option>
|
|
MOZAMBIQUE
|
|
</option>
|
|
|
|
<option>
|
|
NAMIBIA
|
|
</option>
|
|
|
|
<option>
|
|
NAURA
|
|
</option>
|
|
|
|
<option>
|
|
NEPAL
|
|
</option>
|
|
|
|
<option>
|
|
NETHERLANDS
|
|
</option>
|
|
|
|
<option>
|
|
NETHERLANDS ANTILLES
|
|
</option>
|
|
|
|
<option>
|
|
NEVIS
|
|
</option>
|
|
|
|
<option>
|
|
NEW CALEDONIA
|
|
</option>
|
|
|
|
<option>
|
|
NEW ZEALAND
|
|
</option>
|
|
|
|
<option>
|
|
NICARAGUA
|
|
</option>
|
|
|
|
<option>
|
|
NIGER
|
|
</option>
|
|
|
|
<option>
|
|
NIGERIA
|
|
</option>
|
|
|
|
<option>
|
|
NORTHERN IRELAND
|
|
</option>
|
|
|
|
<option>
|
|
NORWAY
|
|
</option>
|
|
|
|
<option>
|
|
OMAN
|
|
</option>
|
|
|
|
<option>
|
|
PAKISTAN
|
|
</option>
|
|
|
|
<option>
|
|
PANAMA
|
|
</option>
|
|
|
|
<option>
|
|
PAPUA NEW GUINEA
|
|
</option>
|
|
|
|
<option>
|
|
PARAGUAY
|
|
</option>
|
|
|
|
<option>
|
|
PERU
|
|
</option>
|
|
|
|
<option>
|
|
PHILIPPINES
|
|
</option>
|
|
|
|
<option>
|
|
PITCAIRN ISLANDS
|
|
</option>
|
|
|
|
<option>
|
|
POLAND
|
|
</option>
|
|
|
|
<option>
|
|
PORTUGAL
|
|
</option>
|
|
|
|
<option>
|
|
QATAR
|
|
</option>
|
|
|
|
<option>
|
|
REUNION
|
|
</option>
|
|
|
|
<option>
|
|
ROMANIA
|
|
</option>
|
|
|
|
<option>
|
|
RUSSIA
|
|
</option>
|
|
|
|
<option>
|
|
RWANDA
|
|
</option>
|
|
|
|
<option>
|
|
SAINT CHRISTOPHER
|
|
</option>
|
|
|
|
<option>
|
|
SAINT HELENA
|
|
</option>
|
|
|
|
<option>
|
|
SAINT KITTS
|
|
</option>
|
|
|
|
<option>
|
|
SAINT LUCIA
|
|
</option>
|
|
|
|
<option>
|
|
SAINT PIERRE and MIQUELON
|
|
</option>
|
|
|
|
<option>
|
|
SAN MARINO
|
|
</option>
|
|
|
|
<option>
|
|
SAINT VINCENT and the GRENADINES
|
|
</option>
|
|
|
|
<option>
|
|
SAUDI ARABIA
|
|
</option>
|
|
|
|
<option>
|
|
SENEGAL
|
|
</option>
|
|
|
|
<option>
|
|
SEYCHELLES
|
|
</option>
|
|
|
|
<option>
|
|
SIERRA LEONE
|
|
</option>
|
|
|
|
<option>
|
|
SINGAPORE
|
|
</option>
|
|
|
|
<option>
|
|
SLOVAK REPUBLIC
|
|
</option>
|
|
|
|
<option>
|
|
SLOVENIA
|
|
</option>
|
|
|
|
<option>
|
|
SOLOMON ISLANDS
|
|
</option>
|
|
|
|
<option>
|
|
SOMALIA
|
|
</option>
|
|
|
|
<option>
|
|
SOUTH AFRICA
|
|
</option>
|
|
|
|
<option>
|
|
SPAIN
|
|
</option>
|
|
|
|
<option>
|
|
SRI LANKA
|
|
</option>
|
|
|
|
<option>
|
|
SUDAN
|
|
</option>
|
|
|
|
<option>
|
|
SURINAME
|
|
</option>
|
|
|
|
<option>
|
|
SWAZILAND
|
|
</option>
|
|
|
|
<option>
|
|
SWEDEN
|
|
</option>
|
|
|
|
<option>
|
|
SWITZERLAND
|
|
</option>
|
|
|
|
<option>
|
|
SYRIA
|
|
</option>
|
|
|
|
<option>
|
|
TAIWAN
|
|
</option>
|
|
|
|
<option>
|
|
TAJIKISTAN
|
|
</option>
|
|
|
|
<option>
|
|
TANZANIA
|
|
</option>
|
|
|
|
<option>
|
|
THAILAND
|
|
</option>
|
|
|
|
<option>
|
|
TOGO
|
|
</option>
|
|
|
|
<option>
|
|
TONGA
|
|
</option>
|
|
|
|
<option>
|
|
TRINIDAD AND TOBAGO
|
|
</option>
|
|
|
|
<option>
|
|
TRISTAN DE CUNHA
|
|
</option>
|
|
|
|
<option>
|
|
TUNISIA
|
|
</option>
|
|
|
|
<option>
|
|
TURKEY
|
|
</option>
|
|
|
|
<option>
|
|
TURKS AND CAICOS IS
|
|
</option>
|
|
|
|
<option>
|
|
TURKMENISTAN
|
|
</option>
|
|
|
|
<option>
|
|
TUVALU
|
|
</option>
|
|
|
|
<option>
|
|
UGANDA
|
|
</option>
|
|
|
|
<option>
|
|
UKRAINE
|
|
</option>
|
|
|
|
<option>
|
|
UNITED ARAB EMIRATES
|
|
</option>
|
|
|
|
<option>
|
|
UNITED STATES
|
|
</option>
|
|
|
|
<option>
|
|
URUGUAY
|
|
</option>
|
|
|
|
<option>
|
|
UZBEKISTAN
|
|
</option>
|
|
|
|
<option>
|
|
VANUATU
|
|
</option>
|
|
|
|
<option>
|
|
VATICAN CITY
|
|
</option>
|
|
|
|
<option>
|
|
VENEZUELA
|
|
</option>
|
|
|
|
<option>
|
|
VIETNAM
|
|
</option>
|
|
|
|
<option>
|
|
WESTERN SAMOA
|
|
</option>
|
|
|
|
<option>
|
|
WALLIS and FUTUNA ISLANDS
|
|
</option>
|
|
|
|
<option>
|
|
YEMEN, REPUBLIC OF
|
|
</option>
|
|
|
|
<option>
|
|
ZAIRE
|
|
</option>
|
|
|
|
<option>
|
|
ZAMBIA
|
|
</option>
|
|
|
|
<option>
|
|
ZIMBABWE
|
|
</option>
|
|
</select> </td>
|
|
</tr>
|
|
|
|
<tr>
|
|
<td>Phone Number:</td>
|
|
|
|
<td><input name="BillTo.Phone" value="" size=
|
|
"30" maxlength="30" type="text"></td>
|
|
</tr>
|
|
|
|
<tr>
|
|
<td colspan="2"><b>Please note:</b> <font size="2">
|
|
For APO or FPO addresses, please enter APO or FPO
|
|
in the <b>CITY</b> field, choose the appropriate
|
|
"AE", "AA" or "AP" code from the <b>STATE</b> list,
|
|
and choose "United States" from the <b>COUNTRY</b>
|
|
list.</font> </td>
|
|
</tr>
|
|
</table>
|
|
<input type="Hidden" name="bill.state" value=""><input
|
|
type="Hidden" name="bill.country" value="">
|
|
<hr size="1">
|
|
<font size="3"><input
|
|
type="radio" value="Y" name="bill.ship_flag" checked
|
|
></font>Ship my orders to this billing address.<br>
|
|
<input type="radio" value="N" name=
|
|
"bill.ship_flag">Enter different shipping address on
|
|
next page.
|
|
<br><input type="submit" value="Continue">
|
|
</form>
|
|
</td>
|
|
</tr>
|
|
|
|
</table>
|
|
|
|
</body>
|
|
</html>
|
|
|