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<?php
if(empty($_REQUEST['user']) || empty($_REQUEST['pass'])) {
header('Location: index.php');
}
session_start();
$error='';
$error='';
$message='';
if (!empty($_POST)) {
//bill user and set next bill date.
}
$title = 'Reactivate Account';
$body_id = 'sub';
require_once("header.php") ?>
<form method="post" action="reactivate.php">
<table cellpadding="0" cellspacing="0" align="center">
<tr>
<td align="left">
<h2>Welcome to Funding Applications!</h2>
<p>There was a problem with your billing information we have on file. Please update your information to reactivate your account.</p>
<div align="center">
<table id="form">
<tr>
<td class="form_top"></td>
</tr>
<tr>
<td class="form_in">
<? if ($error !=''):?>
<div style='background-color:#ffffff; padding:0 20px; margin:0 0 20px 0; border-top:1px dotted #888888; border-bottom:1px dotted #888888'><p style="color:#CA440B">
<?=$error;?>
</p></div>
<? endif;?>
<table align="center">
<tr>
<td style="text-align:right;">Credit Card Number:</td>
<td><input type="text" name="cc_num" size="20" maxlength="16" value="<?= ($cc_num != '') ? $cc_num : NULL; ?>" /></td>
</tr>
<tr>
<td style="text-align:right;">Exp:</td>
<td>
<select name="cc_month">
<option value="MM">MM</option>
<?
for($i = 1; $i <= 12; $i++) {
$month = sprintf('%02s',$i);
$selected = (strcmp($month, $cc_month) == 0) ? "selected" : NULL;
echo "\n<option value='$month' $selected>$month</option>";
}
?>
</select>
<select name="cc_year">
<option value="YYYY">YYYY</option>
<?
$years = range(date('Y'), date('Y')+20);
foreach($years as $year) {
$selected = (strcmp($year, $cc_year) == 0) ? "selected" : NULL;
echo "\n<option value='$year' $selected>$year</option>";
}
?>
</select>
</td>
</tr>
<tr>
<td style="text-align:right;">3 Digit Verification Code<br />on back of Card:</td>
<td><input size=5 maxlength="4" name="cc_cvv" value="<?php echo $cc_cvv ?>" /></td>
</tr>
<tr>
<td colspan="2" align="center">
<input type="hidden" name="user" value="<?= $_REQUEST['user']; ?>" />
<input type="hidden" name="pass" value="<?= $_REQUEST['pass']; ?>" />
<input type="submit" value="Update" style="cursor:pointer" />
</td>
</tr>
<tr height="20">
<td> </td>
</tr>
</table>
</td>
</tr>
<tr>
<td class="form_bot"></td>
</tr>
</table>
</div>
</td>
</tr>
</table>
</form>
<? require_once("footer.php")?>