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<?php
// The variables used in this page are supplied in order.php
?>
<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" >
<html>
<head>
<META HTTP-EQUIV="Content-Type" CONTENT="text/html; charset=UTF-8">
<meta name="viewport" content="width=device-width" />
<title>USA Grant Applications.org - Order Page</title>
<script type="text/javascript" src="/assets/js/jquery-1.11.1.min.js"></script>
<script type="text/javascript" src="/assets/js/orderform_verify.js"></script>
<script type="text/javascript">
function billing_same_as_street_addressf(me) {
if($(me).is(':checked')) {
$('#cardholder_name').val('<?= str_replace("'","\\'",$cc_fname).' '.str_replace("'","\\'",$cc_lname);?>');
$('#billing_street_address').val('<?= str_replace("'","\\'",$cc_addr);?>');
$('#billing_city').val('<?= str_replace("'","\\'",$cc_city);?>');
$('#billing_state').val('<?= str_replace("'","\\'",$cc_state);?>');
$('#billing_zip').val('<?= str_replace("'","\\'",$cc_zip);?>');
} else {
$('#cardholder_name').val('');
$('#billing_street_address').val('');
$('#billing_city').val('');
$('#billing_state').val('');
$('#billing_zip').val('');
}
}
</script>
<style type="text/css">
.thumbnail{
position: relative;
z-index: 0;
text-decoration:none;
}
.thumbnail:hover{
background-color: transparent;
z-index: 50;
}
.thumbnail span{ /*CSS for enlarged image*/
position: absolute;
background-color: #AAD5FF;
width: 300px;
padding: 5px;
left: 250px;
border: 2px dashed #003399;
visibility: hidden;
color: black;
text-decoration: none;
}
.thumbnail span img{ /*CSS for enlarged image*/
border-width: 0;
padding: 2px;
}
.thumbnail:hover span{ /*CSS for enlarged image on hover*/
visibility: visible;
top: 0;
left: 60px; /*position where enlarged image should offset horizontally */
}
-->
</style>
<? include_once("{$_SERVER["DOCUMENT_ROOT"]}/header.php"); ?>
<?php if(isset($error_message)) { ?>
<tr><td colspan="3">
<p style='margin:10px auto;width:90%;border:3px solid #FF0000'>
<center>
The following error has occurred:<br />
<em><?= ($error_message=='Address Verification does not match') ? 'Address Verification does not match.<br />Please be sure the ADDRESS and ZIP CODE match the BILLING address on your CREDIT CARD STATEMENT and enter it in again.' : $error_message;?></em><br />
If you need assistance, please call us at <?= $_SITE_PHONE;?>.
</center>
</p>
</td></tr>
<?php } ?>
<tr>
<td style="background-color:#dbd7d6;text-align:center" valign="top"></td>
<td style="background-color:#ffffff;text-align:left;font:9pt/120% verdana;padding:10px 0px 0px 10px">
<h1 class="header">Step 2 of 3: Confirm your Answers & Complete Registration</h1>
<p>Here is the summary of the answers on step 1 of this USA Grant Application account registration process. Please confirm your answers to be sure they are correct and complete the last step at the bottom of the page. You are 1 step away from beginning the process of applying for funding of every kind if you qualify of course!!</p>
<form action="https://www.usagrantapplications.org/order.php" method="POST" name="orderform" onSubmit="return verify(this);">
<table align="center" cellpadding="3" cellspacing="0" id="payment" class="questions red">
<tr>
<td colspan="2" valign="bottom"><span class="header">Personal Information</span></td>
</tr>
<tr>
<td align="right" class="q">First Name:</td>
<td class="a"><?= $cc_fname; ?><input type="hidden" name="cc_fname" value="<?= $cc_fname; ?>" /></td>
</tr>
<tr>
<td align="right" class="q">Last Name:</td>
<td class="a"><?= $cc_lname; ?><input type="hidden" name="cc_lname" value="<?= $cc_lname; ?>" /></td>
</tr>
<tr>
<td width="124" align="right" nowrap class="q"> My Email Address:</td>
<td width="244" class="a"><?= $cc_email; ?><input type="hidden" name="cc_email" value="<?= $cc_email; ?>" /></td>
</tr>
<tr>
<td align="right" class="q"> Phone Number:</td>
<td class="a">
<?= $cc_phonearea; ?>-<?= $cc_phoneprefix; ?>-<?= $cc_phoneextension; ?>
<input type="hidden" name="cc_phonearea" value="<?= $cc_phonearea; ?>" />
<input type="hidden" name="cc_phoneprefix" value="<?= $cc_phoneprefix; ?>" />
<input type="hidden" name="cc_phoneextension" value="<?= $cc_phoneextension; ?>" />
</td>
</tr>
<tr>
<td align="right" class="q"> Billing Address:</td>
<td class="a"><?= $cc_addr; ?><input type="hidden" name="cc_addr" value="<?= $cc_addr; ?>" /></td>
</tr>
<tr>
<td align="right" class="q"> City:</td>
<td class="a"><?= $cc_city; ?><input type="hidden" name="cc_city" value="<?= $cc_city; ?>" /></td>
</tr>
<tr>
<td align="right" class="q"> State:</td>
<td class="a">
<table cellspacing="0" cellpadding="0" border="0" align="left">
<tr>
<td>
<?= $cc_state; ?><input type="hidden" name="cc_state" value="<?= $cc_state; ?>" />
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td align="right" class="q">Zip Code:</td>
<td class="a"><?= $cc_zip; ?><input type="hidden" name="cc_zip" value="<?= $cc_zip; ?>" /></td>
</tr>
<tr>
<td height="45" colspan="2" valign="bottom"><span class="header">Application Question Summary</span></td>
</tr>
<tr>
<td colspan="2" height="35" class="q">Citizenship Status:</td>
</tr>
<tr>
<td colspan="2"><p class="a"><?= $app_citizenship; ?></p></td>
</tr>
<tr>
<td colspan="2" height="35" class="q">How much money do you need?</td>
</tr>
<tr>
<td colspan="2"><p class="a"><?= $app_amount_needed; ?></p></td>
</tr>
<tr>
<td colspan="2" height="35" class="q">Describe what you will use the money for:</td>
</tr>
<tr>
<td colspan="2"><p class="a"><?= $app_usedescription; ?></p></td>
</tr>
<tr>
<td colspan="2" height="35" class="q">What unique things would separate you from other applicants applying for this money?</td>
</tr>
<tr>
<td colspan="2"><p class="a"><?= stripslashes($app_uniqueness); ?></td>
</tr>
<tr>
<td height="45" colspan="2" valign="bottom"><span class="header">USA Grant Application User Account Info:</span></td>
</tr>
<tr>
<td colspan="2">
<p class="q"><strong>Username for Online Grant Application:</strong></p>
<p class="a"><em>** The Website and Password for the Members site will be given to you at the completion of the registration process</em></p>
</td>
</tr>
<tr>
<td height="45" colspan="2" valign="bottom"><span class="header">Payment Information</span></td>
</tr>
<tr>
<td colspan="2">
<small style="padding:10px 15px; display:inline-block; font-size:10px; color:#222">
Our accountant tells us we have to charge a registration fee to pay our funding writers and provide you with the most up-to-date information from the funding world. <strong>So we have settled on $<?= $_INITIAL_FEE;?>,</strong> which we feel is a fair price to pay for such valuable information, which is updated on a regular basis. <strong> WE ALSO HAVE A GUARANTEE. <u>If you don't qualify for a Grant Program, you will be refunded immediately.</u></strong> Just provide us with the grant application you applied for and the response letter from the grantor. <strong>So, you qualify for a funding program or you will have your payment refunded to you!</strong> <strong>So Start Applying Today!</strong>
</small></td>
</tr>
<?php /*<tr>
<td align="right" nowrap class="q">Credit Card Type:</td>
<td align="left" class="a">
<select name="cc_type">
<option value="Select Card Type">Select Card Type</option>
<option value="Visa" <?php if (strcmp($cc_type,"Visa")==0) { echo "selected";} ?>>Visa</option>
<option value="Mastercard" <?php if (strcmp($cc_type,"Mastercard")==0) { echo "selected";} ?>>Mastercard</option>
</select>
<img src="/images/creditcards.jpg">
</td>
</tr>*/?>
<tr>
<td align="right" class="q">Billing Information</td>
<td align="left" class="a"><label><input type="checkbox" value="1" id="billing_same_as_street_address" name="billing_same_as_street_address" onclick="billing_same_as_street_addressf(this);" /> Same as Street Address</label></td>
</tr>
<tr>
<td align="right" class="q">Cardholder Name</td>
<td align="left" class="a"><input type="text" name="cardholder_name" id="cardholder_name" class="full" maxlength="128" value="<?= $cardholder_name;?>" /></td>
</tr>
<tr>
<td align="right" class="q">Billing Address</td>
<td align="left" class="a"><input type="text" name="billing_street_address" id="billing_street_address" class="full" maxlength="64" value="<?= $billing_street_address;?>" /></td>
</tr>
<tr>
<td align="right" class="q">City</td>
<td align="left" class="a"><input type="text" name="billing_city" id="billing_city" class="full" maxlength="64" value="<?= $billing_city;?>" /></td>
</tr>
<tr>
<td align="right" class="q">State</td>
<td align="left" class="a"><input type="text" name="billing_state" id="billing_state" class="full" maxlength="2" value="<?= $billing_state;?>" /></td>
</tr>
<tr>
<td align="right" class="q">Zip</td>
<td align="left" class="a"><input type="text" name="billing_zip" id="billing_zip" class="full" maxlength="5" value="<?= $billing_zip;?>" /></td>
</tr>
<tr>
<td colspan="3"> </td>
</tr>
<tr>
<td align="right" nowrap class="q">Credit Card Number:</td>
<td class="a">
<input type="tel" maxlength="16" name="cc_num" value="<?php echo $cc_num ?>"></td>
</tr>
<tr>
<td align="right" class="q">Expiration Date:</td>
<td align="left" class="a">
<table border="0" cellspacing="0" cellpadding="0" align="left">
<tr>
<td>
<select name="cc_month">
<option value="MM">MM</option>
<?php
for($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>
</td>
<td>
<select name="cc_year">
<option value="YYYY">YYYY</option>
<?php
$years = range(date('Y'), date('Y')+13);
foreach($years as $year) {
$selected = (strcmp($year, $cc_year) == 0) ? "selected" : NULL;
echo "\n<option value='$year' $selected>$year</option>";
}
?>
</select>
</td>
</tr>
</table>
</td>
</tr>
<tr>
<td align="right" valign="top" nowrap class="q">
Card Verification<br>
Number:
</td>
<td class="a">
<table height="45" border="0" cellpadding="0" cellspacing="0" align="left">
<tr>
<td height="26" valign="top"><input size=5 maxlength="4" type="tel" name="cc_cvv" value="<?php echo $cc_cvv ?>"></td>
<td width=5 valign="top" nowrap> </td>
<td valign="top" class="a">(Last 3 digits on back)</span> </td>
</tr>
<tr>
<td colspan="3">
<div style="float:left;font:8pt/150% verdana;color:#FFFFFF;padding-left:10px;cursor:pointer">
<a class="thumbnail" href="#thumb">
<u>What is this</u>?
<span>
<p style="font:bold 9pt/120% verdana;color:#000066">
Locating your Credit Card CCV/CCV2 Security Code:
</p>
<p><strong>Visa/MasterCard/Discover</strong></p>
<p>Your card security code for your MasterCard or Visa card is a three-digit number on the back of your credit card, immediately following your main card number.</p>
<p><strong>Why do we ask for this?</strong></p>
<p>We ask for this information for your security, as it verifies for us that a credit card is in the physical possesion of the person attempting to use it.</p>
</span>
</a>
</div>
</td>
</tr>
</table>
</td>
</tr>
<?php /*
<tr>
<td colspan="2">
<label><input type="checkbox" name="send_login_text" value="1" checked onclick="if($(this).is(':checked')) { $('#login_text_hidden_box').show(); } else { $('#login_text_hidden_box').hide(); }" /> Send login information in a text</label>
<div id="login_text_hidden_box" style="display:block;">
<label>Cell Phone: <input type="text" name="text_phone" value="<?= $cc_phonearea; ?>-<?= $cc_phoneprefix; ?>-<?= $cc_phoneextension; ?>" /></label>
</div>
</td>
</tr>
*/ ?>
</table>
<?php
//No longer ask if they want a text, just send one
?>
<input type="hidden" name="send_login_text" value="1" />
<input type="hidden" name="text_phone" value="<?= $cc_phonearea; ?>-<?= $cc_phoneprefix; ?>-<?= $cc_phoneextension; ?>" />
<p align="center">
<label for="agree2terms" title="I agree to the terms of this site">
<input type="checkbox" id="agree2terms" name="agree2terms" value="agreed">I agree to the terms of this site
</label>
</p>
<center>
<input type="submit" value="Place Order">
<input type="hidden" name="submitted" value="submitted">
<input type="hidden" name="cc_lead_id" value="<? echo $cc_lead_id; ?>">
</form>
</center>
<br />
<br />
<center>
<table border="0">
<tr>
<!--
<td><img src="/images/privacy.jpg"></td>
//-->
<td>
<img src="/images/ssl_cert.png" />
</td>
<!--
<td><img src="/images/security.jpg"></td>
//-->
</tr>
</table>
</center>
</td>
</tr>
<? include_once("{$_SERVER["DOCUMENT_ROOT"]}/footer.php"); ?>