if (request.productID == null) request.productID = client.productID; Purchasing Information Form

[Order Information Form Graphic]

BILLING INFORMATION
(as it appears on your credit card)

Full Name
Address
City State
Country Zip Code
Billing Phone Email Address

Credit Card // Dynamically construct a list of approved card types from // the CARDTYPE table in the database typeCursor = database.cursor("select * from LP_CARDTYPE"); DynSelect("cardType", 1, false, "", "VISA", typeCursor); typeCursor.close();
Card Number
Expiration Date

SHIPPING ADDRESS

Check if same as above (If checked, any data below is ignored)
Full Name
Address
City State/Province
Country Zip/Postal Code
Contact Phone Email Address