Manual Credit
C
REDIT
C
ARD
I
NFORMATION
Full Name
Credit Card
// Dynamically construct a list of approved card types from // the CARDTYPE table in the database typeCursor = database.cursor("select * from LP_CARDTYPE"); DynSelect("cardType", 1, false, "", "VISA", typeCursor); typeCursor.close();
Card Number
Expiration Date
Jan (1)
Feb (2)
Mar (3)
Apr (4)
May (5)
Jun (6)
Jul (7)
Aug (8)
Sep (9)
Oct (10)
Nov (11)
Dec (12)
1996
1997
1998
1999
2000
2001
2002
2003
2004
DOLLARS
CENTS
Amount to Credit
Credit Description
(Limited to 200 chars)
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