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PHP Hosting Biller 1.0
Order form head file

Please edit the template\head.tpl file.
You can add php code in this file as well.
Please make sure that the space you put for the order form is atleast 430 px wide.

 

 Personal Info:
  *Name:   
  Company:   
  *Street:   
  *City:   
  *State / Province:   
  *Zip / Postal Code:   
  *Country:   
  *Email:   
  *Phone Number:   
 Account Info:
  *Domain:   
  *Username:
  (Between 4 and 8 characters) 		  
  *Password:
  (Between 4 and 8 characters) 		  
 Other:  (optional but recommended)
  AIM:   
  Yahoo:   
  MSN:   
  ICQ:   
  How Here:   
  Comments 
*I have read and agree to the Terms of Service:
 Payment Gateway(s):
Pay securely with your Visa, MasterCard, Discover, or American Express card through PayPal!
 Select Language:
View order form in:   
Changing language will clear contents of form
PHP Hosting Biller 1.0 © 2006 Jnshosts.com

Order form foot file

Please edit the template\foot.tpl file.
You can add php code in this file as well.