[framebase _self] Enter your payment info [body 1]

Credit Card Information

(This is not a secure form.)
[if validcc [value cc_no] [value cc_exp_m]/[value cc_exp_y] [value cc_type]] [set valid_cc]yes[/set] [else] [set valid_cc][/set] [/else] [/if] [if scratch valid_cc] Change credit card info

(A valid [value cc_type] number is on file.
If you need to change it, check the "Change" box above
and click the Change button below.)

[else] Credit Card: Visa Mastercard American Express

[[if value cc_no !~ /^$|NOT_VALID/]

Credit card information not valid

Please check the information you entered and see that the correct card type, expiration date, and number are entered.

[/if]] Card Number Expires [/else] [/if]

[if scratch valid_cc] [else] [/else] [/if]

[[buttonbar 0]]