[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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