[framebase _self]
[if validcc [value cc_no] [value cc_exp] [value cc_type]] Credit Card InfoName
Company Name
Billing address
City
State/Province
Zip/Postal Code
Country [if values country][else][help country_select][/else][/if]
Email Address
Please check the information you entered and see that the correct card type, expiration date, and number are entered.
[/if]] Card Number Expires (mm/yy) [/else] [/if]
Daytime Phone Evening Phone
We need this field to process your order
(enter shipping info if different)
Address City State/Province Zip/Postal Code Country
[row 80] [col 10] Order Code [/col] [col align=l width=7 gutter=1] Quan [/col] [col 30] Description [/col] [col 16 align=r] Price [/col] [/row] [item-list] [row 80] [col 10] [item-code] [/col] [col align=i width=7 gutter=1] [/col] [col 30] [item-description] [/col] [col 16 align=r] $[item-price] [/col] [/row] [/item-list] [row 80] [col 10][/col] [col 7][/col] [column width=30 align=r wrap=no] SUBTOTAL [/column] [column width=16 align=r] [subtotal] [/column] [/row] [row 80] [col 10][/col] [col 7][/col] [column width=30 align=r wrap=no] Sales Tax [/column] [column width=16 align=r] [salestax] [/column] [/row] [row 80] [col 10][/col] [col 7][/col] [column width=30 align=r wrap=no] Shipping [/column] [column width=16 align=r] [shipping] [/column] [/row] [row 80] [col 10][/col] [col 7][/col] [column width=30 align=r wrap=no] TOTAL [/column] [column width=16 align=r] [total-cost] [/column] [/row]
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