<HTML> <HEAD> <TITLE>Forms Sample</TITLE> <SCRIPT TYPE="text/javascript" SRC="/jaxcent21.js"></SCRIPT> </HEAD> <BODY> <FONT SIZE="-1"><A HREF=index.html>Index</A></FONT> <P> Don't be afraid of testing this, these pages are just for demonstration, and you can enter any numbers you like! A string consisting of all zeros will show the message "failed transaction", any other numbers will say it succeeded. <FORM> <TABLE> <TR> <TABLE> <TR> <TD> Credit Card Type </TD> <TD> <SELECT NAME="cardType"> <OPTION>VISA</OPTION> <OPTION>Passport</OPTION> <OPTION>Master Card</OPTION> <OPTION>Green Card</OPTION> </SELECT> </TD> </TR> <TR> <TD> Card Number </TD> <TD> <INPUT TYPE="TEXT" NAME="cardNumber" SIZE="24"> </TD> </TR> <TR> <TD> Card Expiration Month </TD> <TD> <SELECT NAME="cardExpirationMonth"> <OPTION VALUE=1>(01) January</OPTION> <OPTION VALUE=2>(02) February</OPTION> <OPTION VALUE=3>(03) March</OPTION> <OPTION VALUE=4>(04) April</OPTION> <OPTION VALUE=5>(05) May</OPTION> <OPTION VALUE=6>(06) June</OPTION> <OPTION VALUE=7>(07) July</OPTION> <OPTION VALUE=8>(08) August</OPTION> <OPTION VALUE=9>(09) September</OPTION> <OPTION VALUE=10>(10) October</OPTION> <OPTION VALUE=11>(11) November</OPTION> <OPTION VALUE=12>(12) December</OPTION> </SELECT> </TD> </TR> <TR> <TD>Card Expiration Year</TD> <TD> <INPUT NAME="cardExpirationyear" SIZE=4> </TD> </TR> </TABLE> </FORM> <P> <A HREF=Summary.html>Next</A> </BODY> </HTML>