<html>
<title>Abonnement</title>
<script>
var checkobj
function agreesubmit(el){
checkobj=el
if (document.all||document.getElementById){
for (i=0;i<checkobj.form.length;i++){ //hunt down submit button
var tempobj=checkobj.form.elements[i]
if(tempobj.type.toLowerCase()=="submit")
tempobj.disabled=!checkobj.checked
}
}
}
function defaultagree(el){
if (!document.all&&!document.getElementById){
if (window.checkobj&&checkobj.checked)
return true
else{
alert("Please read/accept terms to submit form")
return false
}
}
}
</script>
<p> </p>
<table width="90%" height="90%" border="0" align="center">
<tr>
<th bgcolor="#FFFFFF" scope="col">
<
<!-- <form action="
https://../relay.aspx" method="post"> -->
<form action=".../subscribe/kreditkort.php" method="post">
</p>
<p class="style2">
<input type="hidden" name="MerchantNumber" value="xxxxxxx">
<input type="hidden" name="AddFormPostVars" value="1">
<input type="hidden" name="SHOP_URL" value="../subscribe/kreditkort.php">
</p>
<table width="800" height="121" border="0" align="center">
<tr>
<th scope="col"><div align="left"><span class="style2"><span class="style5">
<input name="belob" type="radio" value="300" checked>
</span></span><span class="style5"> Jeg ønsker og modtage 3 stk.</span><span class="style2"><br>
<input name="belob" type="radio" value="200">
</span><span class="style5">Jeg ønsker at modtage 2 stk. </span><span class="style2"><br>
<input name="belob" type="radio" value="100">
</span><span class="style5">Jeg ønsker bestile 1 stk. </span></div></th>
</tr>
</table>
<p> </p>
<table width="492" border="0" align="center">
<tr>
<th class="style2" scope="col"><div align="left">Navn:</div></th>
<th class="style2" scope="col">
<div align="center">
<input name="Name" id="Name" size="50">
</div></th></tr>
<tr>
<th class="style2" scope="col"><div align="left">Adresse:</div></th>
<th class="style2" scope="col">
<div align="center">
<input name="Address" id="Address" size="50">
</div></th></tr>
<tr>
<th class="style2" scope="col"><div align="left">Post nr. </div></th>
<th class="style2" scope="col">
<div align="center">
<input name="ZipCode" id="ZipCode" size="50">
</div></th></tr>
<tr>
<th class="style2" scope="col"><div align="left">By:</div></th>
<th class="style2" scope="col">
<div align="center">
<input name="City" id="City" size="50">
</div></th></tr>
<tr>
<td class="style2"><div align="left"><strong>E-mail</strong>:</div></td>
<td class="style2">
<div align="center">
<input name="Email" id="Email" size="50">
</div></td>
</tr>
<tr>
<td class="style2"><div align="left"><strong>Telefon:</strong></div></td>
<td class="style2">
<div align="center">
<input name="CustNumber" id="CustNumber" size="50" >
</div></td>
</tr>
</table>
<span class="style2">
<input type="hidden" name="orderid" value=<?php
$stamp = strtotime ("now");
$orderid = "$stamp-$REMOTE_ADDR";
$orderid = str_replace(".", "", "$orderid");
echo($orderid);
?>>
<input type="hidden" name="dateComponents" value=<?php
$dateComponents = getdate($firstDayOfMonth);
echo($dateComponents);
?>>
<input type="hidden" name="periode" value="200">
<label></label>
</p>
</span>
<form name="agreeform" class="style2" onSubmit="return defaultagree(this)">
<input name="agreecheck" type="checkbox" onClick="agreesubmit(this)">
<span class="style7">Jeg har læst og accepteret <a href='../subscribe/conditions.php' target='_blank'>abonnementsvirkår</a>.</span><br><br>
<input type="Submit"disabled value="Forsæt ->" border="0">
</form>
<p class="style2">
<script>
//change two names below to your form's names
document.forms.agreeform.agreecheck.checked=false
</script>
</p><br>
</th>
</tr>
</table>
<p></p>
</body>
</html>
Ny bruger
Nybegynder
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