]> Dogcows Code - chaz/p5-CGI-Ex/blob - samples/app/app1/tt/cust_info.html
CGI::Ex 2.24
[chaz/p5-CGI-Ex] / samples / app / app1 / tt / cust_info.html
1 [% PROCESS "header.tt" title => "Account Information" %]
2
3 <span style="color:green">Congratulations! The test domain <b>[% domain %]</b> is available.</span><br>
4
5 Please enter your account information.
6 <form name=[% form_name %] action=[% script_name %] method=post>
7 <input type=hidden name=domain>
8
9 <table>
10 <tr>
11 <td><label>First Name:</label></td>
12 <td><input type=text name=first_name></td>
13 <td><span class=error id=first_name_error>[% first_name_error %]</span></td>
14 </tr>
15 <tr>
16 <td><label>Last Name:</label></td>
17 <td><input type=text name=last_name></td>
18 <td><span class=error id=last_name_error>[% last_name_error %]</span></td>
19 </tr>
20 <tr>
21 <td><label>Country:</label></td>
22 <td>
23 <select name=country>
24 <option value="">Choose country</option>
25 [%- FOR code IN countries.keys.sort %]
26 <option value="[% code %]">[% countries.$code %]</option>
27 [%- END %]
28 </select>
29 </td>
30 <td><span class=error id=country_error>[% country_error %]</span></td>
31 </tr>
32 <tr>
33 <td><label>Password:</label></td>
34 <td><input type=text name=password></td>
35 <td><span class=error id=password_error>[% password_error %]</span></td>
36 </tr>
37 <tr>
38 <td><label>Password<br>Verify:</label></td>
39 <td><input type=text name=password2></td>
40 <td><span class=error id=password2_error>[% password2_error %]</span></td>
41 </tr>
42
43 <tr>
44 <td colspan=2 align=right>
45 <input type=submit value="Bill me"><br>
46 </td>
47 <td>&nbsp;</td>
48 </tr>
49 </table>
50
51 </form>
52 [% js_validation %]
53
54 [% PROCESS "footer.tt" %]
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