gecko-dev/cmd/dialup/as_html/billing.htm
1998-04-09 04:11:30 +00:00

176 lines
3.8 KiB
HTML

<!-- -*- Mode: HTML; tab-width: 8; indent-tabs-mode: nil -*-
The contents of this file are subject to the Netscape Public License
Version 1.0 (the "NPL"); you may not use this file except in
compliance with the NPL. You may obtain a copy of the NPL at
http://www.mozilla.org/NPL/
Software distributed under the NPL is distributed on an "AS IS" basis,
WITHOUT WARRANTY OF ANY KIND, either express or implied. See the NPL
for the specific language governing rights and limitations under the
NPL.
The Initial Developer of this code under the NPL is Netscape
Communications Corporation. Portions created by Netscape are
Copyright (C) 1998 Netscape Communications Corporation. All Rights
Reserved.
-->
<!DOCTYPE HTML PUBLIC "-//IETF//DTD HTML 3.0//EN">
<HTML>
<HEAD>
<TITLE>Account Setup</TITLE>
<SCRIPT LANGUAGE = "JavaScript" ARCHIVE="asw.jar" SRC="billing.js">
</SCRIPT>
<LINK REL=STYLESHEET TYPE="text/JavaScript" ARCHIVE="asw.jar" HREF="sheet.js">
</LINK>
</HEAD>
<BODY BACKGROUND="images/bg.gif" BGCOLOR="cccccc" onLoad="loadData()" ID="billing100">
<!-- The layer below contains the Account Setup identifier. -->
<LAYER NAME = "tagtext" LEFT = 420 TOP = 0 VISIBILITY = SHOW>
<TABLE BORDER=0 CELLPADDING=0 CELLSPACING=0 WIDTH=200 ID="nospace">
<TR><TD HEIGHT=20 VALIGN=MIDDLE BACKGROUND="images/tag.gif">
<B CLASS="previewtag">ACCOUNT SETUP</B>
</TD></TR>
</TABLE>
</LAYER>
<!-- The layer below contains the headline and text of this screen -->
<FORM>
<P CLASS="title"><B>Your Billing Information</B></P>
<P>Internet accounts are paid for by credit card. Please provide information about the credit card that you would like to use for billing. Account Setup forwards this information to your provider when you create your account. </P>
<CENTER>
<TABLE CELLPADDING="2" CELLSPACING="0" border="0">
<TR>
<TD VALIGN="BOTTOM" ALIGN="RIGHT">
<B>Name on Card:</B>
<spacer type=vertical size=2>
</FONT>
</TD>
<TD ALIGN="LEFT" VALIGN="MIDDLE">
<INPUT NAME="cardname" TYPE="text" SIZE=30 MAXLENGTH=30>
</TD>
</TR>
<TR>
<TD COLSPAN="3">
<spacer type=vertical size=6>
</TD>
</TR>
<TR>
<TD VALIGN="BOTTOM" ALIGN="RIGHT">
<B>Type of Card:</B>
<spacer type=vertical size=4>
</FONT>
</TD>
<TD ALIGN="LEFT" VALIGN="MIDDLE">
<SELECT NAME="cards">
<SCRIPT LANGUAGE="JavaScript" ID="billing101">
generateCards();
</SCRIPT>
</SELECT>
</TD>
</TR>
<TR>
<TD COLSPAN="3">
<spacer type=vertical size=3>
</TD>
</TR>
<TR>
<TD VALIGN="BOTTOM" ALIGN="RIGHT">
<spacer type=vertical size=6>
<B>Card Number:</B>
<spacer type=vertical size=2>
</FONT>
</TD>
<TD ALIGN="LEFT" VALIGN="MIDDLE">
<spacer type=vertical size=4>
<INPUT NAME="cardnumber" TYPE="text" SIZE=25 MAXLENGTH=25>
</TD>
</TR>
<TR>
<TD COLSPAN="3">
<spacer type=vertical size=6>
</TD>
</TR>
<TR>
<TD VALIGN="BOTTOM" ALIGN="RIGHT">
<B>Expiration Date:</B>
<spacer type=vertical size=4>
</FONT>
</TD>
<TD ALIGN="LEFT" VALIGN="MIDDLE">
<SELECT NAME="month">
<OPTION VALUE="January">January
<OPTION VALUE="February">February
<OPTION VALUE="March">March
<OPTION VALUE="April">April
<OPTION VALUE="May">May
<OPTION VALUE="June">June
<OPTION VALUE="July">July
<OPTION VALUE="August">August
<OPTION VALUE="September">September
<OPTION VALUE="October">October
<OPTION VALUE="November">November
<OPTION VALUE="December">December
</SELECT>
<spacer type=horizontal size=2>
<SELECT NAME="year">
<OPTION VALUE="1997">1997
<OPTION VALUE="1998">1998
<OPTION VALUE="1999">1999
<OPTION VALUE="2000">2000
<OPTION VALUE="2001">2001
<OPTION VALUE="2002">2002
<OPTION VALUE="2003">2003
<OPTION VALUE="2004">2004
</SELECT>
</TD>
</TR>
</TABLE>
</CENTER>
</FORM>
</BODY>
</HTML>