|
|
| Line 1: |
Line 1: |
| == BNT-User-Interface-Pages == | | == BNT-User-Interface-Pages == |
|
| |
| <center>
| |
| <FORM name="bill_entry" ACTION=addbill.php METHOD=POST>
| |
| <table border=5 class=body >
| |
| <!-- <Caption>Enter your bill information here:</caption> -->
| |
| <tr><td align=right><label for="denom" accesskey="n"></label>
| |
| De<u>n</u>omination
| |
| <select name="denom" SIZE=1 class=bill_form id="denom" ONCHANGE="ChangeSeries();" >
| |
| <option value="1" SELECTED >$1</option>
| |
| <option value="2" >$2</option>
| |
| <option value="5" >$5</option>
| |
| <option value="10" >$10</option>
| |
| <option value="20" >$20</option>
| |
| <option value="50" >$50</option>
| |
| <option value="100" >$100</option>
| |
| </select></td>
| |
| <td align=left>
| |
| <select name="series" SIZE=1 class=bill_form id=series >
| |
| <option value="-99">Select...</option>
| |
| <option value="2006" >2006</option>
| |
| <option value="2004A" >2004A</option>
| |
| <option value="2004" >2004</option>
| |
| <option value="2003A" >2003A</option>
| |
| <option value="2003" >2003</option>
| |
| <option value="2001" SELECTED >2001</option>
| |
| <option value="1999" >1999</option>
| |
| <option value="1996" >1996</option>
| |
| <option value="1995" >1995</option>
| |
| <option value="1993" >1993</option>
| |
| <option value="1990" >1990</option>
| |
| <option value="1988A" >1988A</option>
| |
| <option value="1988" >1988</option>
| |
| <option value="1985" >1985</option>
| |
| <option value="1981A" >1981A</option>
| |
| <option value="1981" >1981</option>
| |
| <option value="1977A" >1977A</option>
| |
| <option value="1977" >1977</option>
| |
| <option value="1976" >1976</option>
| |
| <option value="1974" >1974</option>
| |
| <option value="1969D" >1969D</option>
| |
| <option value="1969C" >1969C</option>
| |
| <option value="1969B" >1969B</option>
| |
| <option value="1969A" >1969A</option>
| |
| <option value="1969" >1969</option>
| |
| <option value="1966A" >1966A</option>
| |
| <option value="1966" >1966</option>
| |
| <option value="1963B" >1963B</option>
| |
| <option value="1963A" >1963A</option>
| |
| <option value="1963" >1963</option>
| |
| </select> <label for="series" accesskey="b"></label>
| |
| <u>B</u>ill Series (2006 is THIRD on the list)
| |
| </td>
| |
| </tr>
| |
| <tr>
| |
| <td align=right>
| |
|
| |
| <input type=hidden name=d0 value=276>
| |
| <input type=hidden name=d1 value=651>
| |
| <input type=hidden name=d2 value=153>
| |
| <input type=hidden name=d3 value=316>
| |
| <input type=hidden name=d4 value=882> <label for="a2db1840f8bbcfa8972172d6648d693375f4c0aa5fc6a1e55" accesskey="s"></label>
| |
| <u>S</u>erial Number
| |
| <INPUT class=bill_form type=text maxlength=11 size=13 id="a2db1840f8bbcfa8972172d6648d693375f4c0aa5fc6a1e55" name=a2db1840f8bbcfa8972172d6648d693375f4c0aa5fc6a1e55 value='' ><br><b>(10 or 11 chars)</b><br>If the serial number has a 'star'<br>use the * key (shift-8)
| |
| </td>
| |
| <td align=left>
| |
| <INPUT class=bill_form type=text maxlength=7 size=6 id=zipcode name=zip VALUE="">
| |
| <label for="zipcode" accesskey="z"></label>
| |
| Current <u>Z</u>ip/Postal Code
| |
| <br><B>(USA or Canada ONLY)</b>
| |
| <br>International Users-<script>document.write("<A HREF=\"javascript:popup_win('country_popup.php',400,500,'no');\">Click Here</a>");</script><noscript><A HREF=country_popup.php target=_blank>Click Here</a></noscript> <br>Don't know your Zip code? <script>document.write("<A HREF=\"javascript:popup_win('new_zip_popup.php',400,500,'no');\">Click Here</a>");</script><noscript><A HREF=new_zip_popup.php target=_blank>Click Here</a></noscript> </td>
| |
| </tr>
| |
| <tr><td align=right>
| |
| Do you have this bill right now?</td><td align=left>
| |
| <input type="radio" name="dohave" value="Y" checked >Yes <input type="radio" name="dohave" value="N">No
| |
| </td></tr>
| |
| <tr>
| |
| <td align=center colspan=2>Please enter a short note about this bill if you like:<br>
| |
| (Where did you get it, its condition, etc...Five lines maximum).<br><script language="javascript" src="/textcounter.js"></script><textarea class="bill_form" name="notes" id="notes" COLS="50" ROWS="4" wrap onKeyUp="textCounter('notes',255,'notes_textcnt');"></textarea><br><script language="javascript" type="text/javascript">document.write("Characters Remaining:<span id=\"notes_textcnt\">255</span><br>");textCounter('notes',255,'notes_textcnt');</script><BR><INPUT type="submit" value="Submit this Bill"></td></tr></table></FORM>
| |
| <script LANGUAGE="JavaScript" type="text/javascript">init("");</script></center>
| |
|
| |
|
| == BNT-DataBase-Table-Design == | | == BNT-DataBase-Table-Design == |