{template "phpcms","header"}
<script language="javascript">
<!--
function CheckForm() {
if ($F('amount') == "")
	{
	    alert("請輸入支付金額！")
		Field.clear('amount')
		Field.focus('amount');
	    return false
	 }
if ($F('contactname') == "")
	{
	    alert("請輸入聯繫人姓名！")
		Field.clear('contactname')
		Field.focus('contactname');
	    return false
	 }
if ($F('telephone') == "")
	{
	    alert("請輸入聯繫電話！")
		Field.clear('telephone')
		Field.focus('telephone');
	    return false
	 }
if ($F('email') == "")
	{
	    alert("請輸入E-mail！")
		Field.clear('email')
		Field.focus('email');
	    return false
	 }
    document.myform.submit.disabled = true;
}
//-->
</script>

<table cellspacing="0" cellpadding="0" width="980">
<tr>
<td valign="top" class="left">
{template "member","left"}
</td>
<td width="10" valign="top">
</td>
<td class="right" valign="top">
<div class="memberborder_1">
<div class="memberborder_2">
<h1>在線支付</h1>
<form name="myform" method="post" action="{$MOD[linkurl]}payonline_confirm.php"  onSubmit="return CheckForm();">
  <table cellpadding="2" cellspacing="1" class="righttable">
    <tr>
      <td width="120" class="td_right">支付金額：</td>
      <td class="td_left"><input name="amount" type="text" size="10" value="{$amount}"> 元</td>
    </tr>
    <tr >
      <td class="td_right">支付平台：</td>
      <td class="td_left">
<select name="paycenter">
{loop $payonline_setting $paycenter $pay}
<option value="{$pay[paycenter]}" {$selected[$paycenter]}>{$pay[name]}</option>
{/loop}
</select>
</td>
    </tr>
    <tr>
      <td class="td_right">聯繫人：</td>
      <td class="td_left"><input name="contactname" type="text" size="30"  value="{$contactname}"></td>
    </tr>
    <tr>
      <td class="td_right">聯繫電話：</td>
      <td class="td_left"><input name="telephone" type="text" size="30" value="{$telephone}"></td>
    </tr>
    <tr>
      <td class="td_right">E-mail：</td>
      <td class="td_left"><input name="email" type="text" size="30" value="{$email}"></td>
    </tr>
    <tr >
      <td class="td_right">
      </td>
      <td height="40" class="td_left">
        <input name="forward" type="hidden" value="{$forward}">
        <input name="dosubmit" type="submit" value=" 下一步 ">
      </td>
    </tr>
  </table>
</form>
</div></div>
</td>
</tr>
</table>
{template "phpcms","footer"}