source: branches/beta/data/downloads/module/mdl_paygent/paygent_conveni_mobile.tpl @ 16946

<center><!--{$tpl_payment_method}--></center>

<hr>

<form name="form1" method="post" action="<!--{$smarty.server.PHP_SELF|escape}-->">
<input type="hidden" name="mode" value="next">
<input type="hidden" name="uniqid" value="<!--{$tpl_uniqid}-->">

<!--{if $tpl_error != ""}-->
<font color="#ff0000"><!--{$tpl_error}--></font><br><br>
<!--{/if}-->

²¼µ­¤ËɬÍ×»ö¹à¤òÆþÎϤ·¤Æ¤¯¤À¤µ¤¤¡£<br><br>

<!--{if $tpl_payment_image != ""}-->
¤´ÍøÍѤ¤¤¿¤À¤±¤ë¥³¥ó¥Ó¥Ë¤Î¼ïÎà<br>
<img src="<!--{$smarty.const.IMAGE_SAVE_URL}--><!--{$tpl_payment_image}-->"><br><br>
<!--{/if}-->

¥³¥ó¥Ó¥ËÁªÂò<br>
<!--{assign var=key1 value="cvs_company_id"}-->
<font color="#ff0000"><!--{$arrErr[$key1]}--></font>
<select name="<!--{$key1}-->" value="<!--{$arrForm[$key1].value|escape}-->" maxlength="<!--{$arrForm[$key1].length}-->">
<option value="">¤´ÁªÂò¤¯¤À¤µ¤¤</option>
<!--{html_options options=$arrConvenience selected=$arrForm[$key1].value}-->
</select>
<br><br>

ÍøÍѼÔ<br>
<font size="2">¢¨ Æüì¤Ê´Á»ú¤Ï»ÈÍѤǤ­¤Ê¤¤¾ì¹ç¤¬¤´¤¶¤¤¤Þ¤¹¡£</font><br>
<!--{assign var=key1 value="customer_family_name"}-->
<!--{assign var=key2 value="customer_name"}-->
<font color="#ff0000"><!--{$arrErr[$key1]}--></font>
<font color="#ff0000"><!--{$arrErr[$key2]}--></font>
À«<input type="text" name="<!--{$key1}-->" value="<!--{$arrForm[$key1].value|escape}-->" istyle="1" size="15"><br>
̾<input type="text" name="<!--{$key2}-->" value="<!--{$arrForm[$key2].value|escape}-->" istyle="1" size="15">
<br><br>

ÍøÍѼÔ(¥«¥Ê)<br>
<font size="2">¢¨¥«¥Ê¤ËÂùÅÀ¡Ê¡«¡Ë¤äȾÂùÅÀ¡Ê¡¬¡Ë¤¬¤¢¤ë¾ì¹ç¡¢³ºÅöµ­¹æ¤Î¤ß½ü³°¤µ¤ì¤Þ¤¹¡£Í½¤á¤´Î»¾µ¤¯¤À¤µ¤¤¡£</font><br>
<!--{assign var=key1 value="customer_family_name_kana"}-->
<!--{assign var=key2 value="customer_name_kana"}-->
<font color="#ff0000"><!--{$arrErr[$key1]}--></font>
<font color="#ff0000"><!--{$arrErr[$key2]}--></font>
¥»¥¤<input type="text" name="<!--{$key1}-->" value="<!--{$arrForm[$key1].value|escape}-->" istyle="2" size="15"><br>
¥á¥¤<input type="text" name="<!--{$key2}-->" value="<!--{$arrForm[$key2].value|escape}-->" istyle="2" size="15">
<br><br>

¤ªÅÅÏÃÈÖ¹æ<br>
<!--{assign var=key1 value="customer_tel"}-->
<font color="#ff0000"><!--{$arrErr[$key1]}--></font>
<input type="text" name="<!--{$key1}-->" value="<!--{$arrForm[$key1].value|escape}-->" istyle="4" size="20">
<br><br>

<br>

°Ê¾å¤ÎÆâÍƤǴְ㤤¤Ê¤±¤ì¤Ð¡¢²¼µ­¡Ö¼¡¤Ø¡×¥Ü¥¿¥ó¤ò¥¯¥ê¥Ã¥¯¤·¤Æ¤¯¤À¤µ¤¤¡£<br>
<font size="2" color="#ff6600">¢¨²èÌ̤¬ÀÚ¤êÂؤë¤Þ¤Ç¾¯¡¹»þ´Ö¤¬¤«¤«¤ë¾ì¹ç¤¬¤´¤¶¤¤¤Þ¤¹¤¬¡¢¤½¤Î¤Þ¤Þ¤ªÂÔ¤Á¤¯¤À¤µ¤¤¡£</font><br>
<center><input type="submit" value="¼¡¤Ø">
</form>
<form action="./load_payment_module.php" method="post">
<input type="hidden" name="mode" value="return">
<input type="submit" value="Ìá¤ë"></center>
</form>

<br>
<hr>

<a href="<!--{$smarty.const.URL_CART_TOP}-->" accesskey="9"><!--{9|numeric_emoji}-->¤«¤´¤ò¸«¤ë</a><br>
<a href="<!--{$smarty.const.URL_SITE_TOP}-->" accesskey="0"><!--{0|numeric_emoji}-->TOP¥Ú¡¼¥¸¤Ø</a><br>

<br>

<!-- ¢§¥Õ¥Ã¥¿¡¼ ¤³¤³¤«¤é -->
<center>LOCKON CO.,LTD.</center>
<!-- ¢¥¥Õ¥Ã¥¿¡¼ ¤³¤³¤Þ¤Ç -->