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[chromium-blink-merge.git] / chrome / test / data / autofill / heuristics / input / 04_checkout_jr.com.html
blob4d707c6c4c2c1e2e4747e70f0696f16b7aad28d6
2 <!DOCTYPE html PUBLIC
3 "-//W3C//DTD XHTML 1.0 Transitional//EN"
4 "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
5 <html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
6 <head>
7 <title>
8 Secure Checkout at JR.com
9 </title>
10 <meta http-equiv="content-type" content="iso-8859-1" />
11 <meta name="MSSmartTagsPreventParsing" content="TRUE" />
12 <meta name="autosize" content="off" />
13 <meta http-equiv="imagetoolbar" content="no" />
14 <meta name="robots" content="noindex,nofollow" />
15 <meta name="description" content="Checkout at J&amp;R Music &amp; Computer World" />
16 </head>
17 <body class="yui-skin-clint yui-skin-sam" >
21 <form method="POST" id="addressForm">
24 <div class="yui-g">
25 <div class="yui-u first">
26 <div class="pageHeader">
27 Billing and Shipping Addresses </div>
28 </div>
29 <div class="yui-u jrui-right">
30 <input type="hidden" name="_flowExecutionKey" value="_c1CD2F5A1-28EE-6B0F-71FC-DCDBE4BCCA78_k64250CE6-ADB4-BD9D-FEED-2C51C69CE671" />
31 <input type="image" name="_eventId_continue" value="submit" alt="Continue" src="#" />
32 </div>
33 </div>
36 <div class="yui-g">
37 <div class="yui-u first firstCol">
38 <div class="subHead">
39 Billing Address <span class="subNote">&nbsp;&nbsp;&nbsp; <span class='asterisk'>*</span>
40 required fields</span>
41 </div>
42 <div class="subNote">
43 Please enter info as it appears on your credit card statement.</div>
45 <div class="addressRowGroup">
46 <div class="addressCell">
47 <div>
48 <div class='mark asterisk'> &nbsp; </div>
49 <div class="field label">
50 First Name </div>
51 </div>
52 <div>
53 <div class='mark asterisk'> * </div>
54 <input type="text" id="billingAddress.firstName" name="billingAddress.firstName" value="" style='width: 124px' maxlength='14' >
56 </div>
57 <div>
58 </div>
59 </div>
61 <div class="addressCell">
62 <div>
63 <div class='mark asterisk'> &nbsp; </div>
64 <div class="field label">
65 Last Name </div>
66 </div>
67 <div>
68 <div class='mark asterisk'> * </div>
69 <input type="text" id="billingAddress.lastName" name="billingAddress.lastName" value="" style='width: 124px' maxlength='15' >
71 </div>
72 <div>
73 </div>
74 </div>
76 <div style="clear: both;"></div>
77 </div>
79 <div class="addressRowGroup">
80 <div class="addressRow">
81 <div class='mark asterisk'> &nbsp; </div>
82 <div class="field label">
83 Address </div>
84 </div>
86 <div class="addressRow">
87 <div class='mark asterisk'> * </div>
88 <div> <input type="text" id="billingAddress.address1" name="billingAddress.address1" value="" style='width: 275px' maxlength='30' >
90 </div>
91 </div>
93 <div class="addressRow">
94 <div class='mark asterisk'> &nbsp; </div>
95 <div class="field subNote">
96 Street address or P.O. box </div>
97 </div>
101 <div class="addressRow">
102 <div class='mark asterisk'> &nbsp; </div>
103 <div class="field"> <input type="text" id="billingAddress.address2" name="billingAddress.address2" value="" style='width: 275px' maxlength='30' >
105 </div>
107 </div>
109 <div class="addressRow">
110 <div class='mark asterisk'> &nbsp; </div>
111 <div class="field subNote">
112 Apartment, suite, company, care of, etc. </div>
113 </div>
114 </div>
116 <div class="addressRowGroup">
118 <div class="addressRow">
119 <div class='mark asterisk'> &nbsp; </div>
120 <div class="field label">City</div>
121 </div>
123 <div class="addressRow">
124 <div class='mark asterisk'> * </div>
125 <div class="field">
126 <input type="text" id="billingAddress.city" name="billingAddress.city" value="" style='width: 275px' maxlength='20' >
128 </div>
129 </div>
131 <div class="addressRow">
132 <div class='mark asterisk'> &nbsp; </div>
133 <div class="field subNote">
134 Enter APO or FPO in the City field above
135 </div>
136 </div>
140 </div>
142 <div class="addressRowGroup">
144 <div class="addressCell" style="width: 215px;">
146 <div class='mark asterisk'> &nbsp; </div>
147 <div class="field label">State/Province</div>
149 <div class='mark asterisk'> * </div>
150 <div class="field">
151 <select id="billingAddress.stateCode" name="billingAddress.stateCode" >
152 <option value="XX"
154 >Select a State:</option>
155 <option value="AA"
157 >AA - Armed Forces America</option>
158 <option value="AE"
160 >AE - Armed Forces Europe</option>
161 <option value="AK"
163 >AK - Alaska</option>
164 <option value="AL"
166 >AL - Alabama</option>
167 <option value="AP"
169 >AP - Armed Forces Pacific</option>
170 <option value="AR"
172 >AR - Arkansas</option>
173 <option value="AS"
175 >AS - American Somoa</option>
176 <option value="AZ"
178 >AZ - Arizona</option>
179 <option value="CA"
181 >CA - California</option>
182 <option value="CO"
184 >CO - Colorado</option>
185 <option value="CT"
187 >CT - Connecticut</option>
188 <option value="DC"
190 >DC - District of Columbia</option>
191 <option value="DE"
193 >DE - Delaware</option>
194 <option value="FL"
196 >FL - Florida</option>
197 <option value="FM"
199 >FM - FS of Micronesia</option>
200 <option value="GA"
202 >GA - Georgia</option>
203 <option value="GU"
205 >GU - Guam</option>
206 <option value="HI"
208 >HI - Hawaii</option>
209 <option value="IA"
211 >IA - Iowa</option>
212 <option value="ID"
214 >ID - Idaho</option>
215 <option value="IL"
217 >IL - Illinois</option>
218 <option value="IN"
220 >IN - Indiana</option>
221 <option value="KS"
223 >KS - Kansas</option>
224 <option value="KY"
226 >KY - Kentucky</option>
227 <option value="LA"
229 >LA - Louisiana</option>
230 <option value="MA"
232 >MA - Massachusetts</option>
233 <option value="MD"
235 >MD - Maryland</option>
236 <option value="ME"
238 >ME - Maine</option>
239 <option value="MH"
241 >MH - Marshall Islands</option>
242 <option value="MI"
244 >MI - Michigan</option>
245 <option value="MN"
247 >MN - Minnesota</option>
248 <option value="MO"
250 >MO - Missouri</option>
251 <option value="MP"
253 >MP - Mariana Islands</option>
254 <option value="MS"
256 >MS - Mississippi</option>
257 <option value="MT"
259 >MT - Montana</option>
260 <option value="NC"
262 >NC - North Carolina</option>
263 <option value="ND"
265 >ND - North Dakota</option>
266 <option value="NE"
268 >NE - Nebraska</option>
269 <option value="NH"
271 >NH - New Hampshire</option>
272 <option value="NJ"
274 >NJ - New Jersey</option>
275 <option value="NM"
277 >NM - New Mexico</option>
278 <option value="NV"
280 >NV - Nevada</option>
281 <option value="NY"
283 >NY - New York</option>
284 <option value="OH"
286 >OH - Ohio</option>
287 <option value="OK"
289 >OK - Oklahoma</option>
290 <option value="OR"
292 >OR - Oregon</option>
293 <option value="PA"
295 >PA - Pennsylvania</option>
296 <option value="PR"
298 >PR - Puerto Rico</option>
299 <option value="PW"
301 >PW - Palau</option>
302 <option value="RI"
304 >RI - Rhode Island</option>
305 <option value="SC"
307 >SC - South Carolina</option>
308 <option value="SD"
310 >SD - South Dakota</option>
311 <option value="TN"
313 >TN - Tennessee</option>
314 <option value="TX"
316 >TX - Texas</option>
317 <option value="UT"
319 >UT - Utah</option>
320 <option value="VA"
322 >VA - Virginia</option>
323 <option value="VI"
325 >VI - Virgin Islands</option>
326 <option value="VT"
328 >VT - Vermont</option>
329 <option value="WA"
331 >WA - Washington</option>
332 <option value="WI"
334 >WI - Wisconsin</option>
335 <option value="WV"
337 >WV - West Virginia</option>
338 <option value="WY"
340 >WY - Wyoming</option>
341 <option value="XY"
343 >Select a Province:</option>
344 <option value="AB"
346 >AB - Alberta</option>
347 <option value="BC"
349 >BC - British Columbia</option>
350 <option value="MB"
352 >MB - Manitoba</option>
353 <option value="NU"
355 >NU - Nunavut</option>
356 <option value="NB"
358 >NB - New Brunswick</option>
359 <option value="NF"
361 >NF - Newfoundland</option>
362 <option value="NT"
364 >NT - Northwest Territories</option>
365 <option value="NS"
367 >NS - Nova Scotia</option>
368 <option value="ON"
370 >ON - Ontario</option>
371 <option value="PE"
373 >PE - Prince Edward Island</option>
374 <option value="QC"
376 >QC - Quebec</option>
377 <option value="SK"
379 >SK - Saskatchewan</option>
380 <option value="YT"
382 >YT - Yukon Territory</option>
383 <option value="XQ"
385 >International</option>
386 </select>
387 </div>
390 </div>
392 <div class="addressCell" style="width: 150px;">
393 <div class='mark asterisk'> &nbsp; </div>
394 <div class="field label">ZIP/Postal Code</div>
396 <div class='mark asterisk'> * </div>
397 <div class="field">
398 <input type="text" id="billingAddress.postalCode" name="billingAddress.postalCode" value="" style='width: 90px' maxlength='10' >
400 </div>
403 </div>
405 <div style="clear: both;"></div>
406 </div>
409 <div class="addressRowGroup">
411 <div class="addressRow">
412 <div class='mark asterisk'> &nbsp; </div>
413 <div class="field label">Country</div>
414 </div>
416 <div class="addressRow">
417 <div class='mark asterisk'> * </div>
418 <div class="field">
419 <select id="billingAddress.country" name="billingAddress.country" >
420 <option value="US"
422 >United States</option>
423 <option value="CA"
425 >Canada</option>
426 </select>
427 <span style="margin-left: 10px">
429 target="nonUSBill"
430 href="http://www.jr.com/information/pop_nonUSBilling.jsp">International billing instructions</a>
431 </span>
432 </div>
433 </div>
437 </div>
439 <div class="addressRowGroup">
441 <div class="addressRow">
442 <div class='mark asterisk'> &nbsp; </div>
443 <div class="field label">Contact Phone Number</div>
444 </div>
446 <div class="addressRow">
447 <div class='mark asterisk'> * </div>
448 <div class="field">
449 <input type="text" id="billingAddress.phoneNumber" name="billingAddress.phoneNumber" value="" maxlength='18' size='18' style='width: 120px;' >
451 </div>
452 </div>
453 <div class="addressRow">
454 <div class='mark asterisk'> &nbsp; </div>
455 <div class="field subNote">Used only for billing inquiries</div>
456 </div>
460 </div>
462 <div class="addressRowGroup">
464 <div class="addressRow">
465 <div class='mark asterisk'> &nbsp; </div>
466 <div class="field label">Email Address</div>
467 </div>
469 <div class="addressRow">
470 <div class='mark asterisk'> * </div>
471 <div class="field">
472 <input type="text" id="customer.emailAddress" name="customer.emailAddress" value="" maxlength='50' style='width: 275px' >
474 </div>
475 </div>
480 </div>
482 <div class="addressRowGroup">
483 <div class="addressRow">
484 <div class='mark asterisk'> &nbsp; </div>
485 <span class="field">
486 <input type="hidden" name="_customer.optIn" value="false" />
487 <input type="checkbox" id="customer.optIn" name="customer.optIn"
488 checked="checked"
491 <label for="customer.optIn">Yes, send me J&amp;R's promotional email newsletter.</label>
492 </span>
493 </div>
495 </div>
497 </div>
498 <div class="yui-u">
500 <div class="subHead">Shipping Address</div>
501 <div style="margin-top: 20px;">
503 <span> <input type="hidden" name="_storePickup" value="false" />
504 <input type="checkbox" id="storePickup" name="storePickup"
507 </span>
508 <span class="keyOption"><label for="storePickup">Pickup In-Store (Park Row, New York NY)</label></span>
509 </div>
511 <div id="shipToBillingDiv" style="margin-top: 10px;">
513 <div>
514 <span> <input type="hidden" name="_shipToBillingAddress" value="false" />
515 <input type="checkbox" id="shipToBillingAddress" name="shipToBillingAddress"
519 </span>
520 <span class="keyOption"><label for="shipToBillingAddress">Ship to my billing address</label></span>
521 </div>
523 <div style="padding-left: 18px; padding-right: 70px;">
524 <div class='mark asterisk'> &nbsp; </div>
525 <div class="subNote"><font color='#990000' style='font-weight: bold'>SAVE TIME!</font>
526 If your shipping address is the same as your billing address, it will expedite your order.</div>
527 </div>
529 </div>
531 <div id="shippingAddressFields">
533 <div style='margin-bottom: 4px'> </div>
536 <div class="addressRowGroup">
537 <div class="addressCell">
538 <div>
539 <div class='mark asterisk'> &nbsp; </div>
540 <div class="field label">
541 First Name </div>
542 </div>
543 <div>
544 <div class='mark asterisk'> * </div>
545 <input type="text" id="shippingAddress.firstName" name="shippingAddress.firstName" value="" style='width: 124px' maxlength='14' >
547 </div>
548 <div>
549 </div>
550 </div>
552 <div class="addressCell">
553 <div>
554 <div class='mark asterisk'> &nbsp; </div>
555 <div class="field label">
556 Last Name </div>
557 </div>
558 <div>
559 <div class='mark asterisk'> * </div>
560 <input type="text" id="shippingAddress.lastName" name="shippingAddress.lastName" value="" style='width: 124px' maxlength='15' >
562 </div>
563 <div>
564 </div>
565 </div>
567 <div style="clear: both;"></div>
568 </div>
570 <div class="addressRowGroup">
571 <div class="addressRow">
572 <div class='mark asterisk'> &nbsp; </div>
573 <div class="field label">
574 Address </div>
575 </div>
577 <div class="addressRow">
578 <div class='mark asterisk'> * </div>
579 <div> <input type="text" id="shippingAddress.address1" name="shippingAddress.address1" value="" style='width: 275px' maxlength='30' >
581 </div>
583 </div>
585 <div class="addressRow">
586 <div class='mark asterisk'> &nbsp; </div>
587 <div class="field subNote">
588 Street address or P.O. box </div>
589 </div>
593 <div class="addressRow">
594 <div class='mark asterisk'> &nbsp; </div>
595 <div class="field"> <input type="text" id="shippingAddress.address2" name="shippingAddress.address2" value="" style='width: 275px' maxlength='30' >
597 </div>
599 </div>
601 <div class="addressRow">
602 <div class='mark asterisk'> &nbsp; </div>
603 <div class="field subNote">
604 Apartment, suite, company, care of, etc. </div>
605 </div>
606 </div>
608 <div class="addressRowGroup">
610 <div class="addressRow">
611 <div class='mark asterisk'> &nbsp; </div>
612 <div class="field label">City</div>
613 </div>
615 <div class="addressRow">
616 <div class='mark asterisk'> * </div>
617 <div class="field">
618 <input type="text" id="shippingAddress.city" name="shippingAddress.city" value="" style='width: 275px' maxlength='20' >
620 </div>
621 </div>
623 <div class="addressRow">
624 <div class='mark asterisk'> &nbsp; </div>
625 <div class="field subNote">
626 Enter APO or FPO in the City field above
627 </div>
628 </div>
631 </div>
633 <div class="addressRowGroup">
634 <div class="addressCell" style="width: 205px;">
635 <div>
636 <div class='mark asterisk'> &nbsp; </div>
637 <div class="field label">State/Province</div>
638 </div>
640 <div>
641 <div class='mark asterisk'> * </div>
642 <div class="field">
643 <select id="shippingAddress.stateCode" name="shippingAddress.stateCode" >
644 <option value="XX"
646 >Select a State:</option>
647 <option value="AA"
649 >AA - Armed Forces America</option>
650 <option value="AE"
652 >AE - Armed Forces Europe</option>
653 <option value="AK"
655 >AK - Alaska</option>
656 <option value="AL"
658 >AL - Alabama</option>
659 <option value="AP"
661 >AP - Armed Forces Pacific</option>
662 <option value="AR"
664 >AR - Arkansas</option>
665 <option value="AS"
667 >AS - American Somoa</option>
668 <option value="AZ"
670 >AZ - Arizona</option>
671 <option value="CA"
673 >CA - California</option>
674 <option value="CO"
676 >CO - Colorado</option>
677 <option value="CT"
679 >CT - Connecticut</option>
680 <option value="DC"
682 >DC - District of Columbia</option>
683 <option value="DE"
685 >DE - Delaware</option>
686 <option value="FL"
688 >FL - Florida</option>
689 <option value="FM"
691 >FM - FS of Micronesia</option>
692 <option value="GA"
694 >GA - Georgia</option>
695 <option value="GU"
697 >GU - Guam</option>
698 <option value="HI"
700 >HI - Hawaii</option>
701 <option value="IA"
703 >IA - Iowa</option>
704 <option value="ID"
706 >ID - Idaho</option>
707 <option value="IL"
709 >IL - Illinois</option>
710 <option value="IN"
712 >IN - Indiana</option>
713 <option value="KS"
715 >KS - Kansas</option>
716 <option value="KY"
718 >KY - Kentucky</option>
719 <option value="LA"
721 >LA - Louisiana</option>
722 <option value="MA"
724 >MA - Massachusetts</option>
725 <option value="MD"
727 >MD - Maryland</option>
728 <option value="ME"
730 >ME - Maine</option>
731 <option value="MH"
733 >MH - Marshall Islands</option>
734 <option value="MI"
736 >MI - Michigan</option>
737 <option value="MN"
739 >MN - Minnesota</option>
740 <option value="MO"
742 >MO - Missouri</option>
743 <option value="MP"
745 >MP - Mariana Islands</option>
746 <option value="MS"
748 >MS - Mississippi</option>
749 <option value="MT"
751 >MT - Montana</option>
752 <option value="NC"
754 >NC - North Carolina</option>
755 <option value="ND"
757 >ND - North Dakota</option>
758 <option value="NE"
760 >NE - Nebraska</option>
761 <option value="NH"
763 >NH - New Hampshire</option>
764 <option value="NJ"
766 >NJ - New Jersey</option>
767 <option value="NM"
769 >NM - New Mexico</option>
770 <option value="NV"
772 >NV - Nevada</option>
773 <option value="NY"
775 >NY - New York</option>
776 <option value="OH"
778 >OH - Ohio</option>
779 <option value="OK"
781 >OK - Oklahoma</option>
782 <option value="OR"
784 >OR - Oregon</option>
785 <option value="PA"
787 >PA - Pennsylvania</option>
788 <option value="PR"
790 >PR - Puerto Rico</option>
791 <option value="PW"
793 >PW - Palau</option>
794 <option value="RI"
796 >RI - Rhode Island</option>
797 <option value="SC"
799 >SC - South Carolina</option>
800 <option value="SD"
802 >SD - South Dakota</option>
803 <option value="TN"
805 >TN - Tennessee</option>
806 <option value="TX"
808 >TX - Texas</option>
809 <option value="UT"
811 >UT - Utah</option>
812 <option value="VA"
814 >VA - Virginia</option>
815 <option value="VI"
817 >VI - Virgin Islands</option>
818 <option value="VT"
820 >VT - Vermont</option>
821 <option value="WA"
823 >WA - Washington</option>
824 <option value="WI"
826 >WI - Wisconsin</option>
827 <option value="WV"
829 >WV - West Virginia</option>
830 <option value="WY"
832 >WY - Wyoming</option>
833 <option value="XY"
835 >Select a Province:</option>
836 <option value="AB"
838 >AB - Alberta</option>
839 <option value="BC"
841 >BC - British Columbia</option>
842 <option value="MB"
844 >MB - Manitoba</option>
845 <option value="NU"
847 >NU - Nunavut</option>
848 <option value="NB"
850 >NB - New Brunswick</option>
851 <option value="NF"
853 >NF - Newfoundland</option>
854 <option value="NT"
856 >NT - Northwest Territories</option>
857 <option value="NS"
859 >NS - Nova Scotia</option>
860 <option value="ON"
862 >ON - Ontario</option>
863 <option value="PE"
865 >PE - Prince Edward Island</option>
866 <option value="QC"
868 >QC - Quebec</option>
869 <option value="SK"
871 >SK - Saskatchewan</option>
872 <option value="YT"
874 >YT - Yukon Territory</option>
875 <option value="XQ"
877 >International</option>
878 </select>
879 </div>
880 </div>
884 </div>
886 <div class="addressCell" style="width: 170px;">
887 <div>
888 <div class='mark asterisk'> &nbsp; </div>
889 <div class="field label">ZIP/Postal Code</div>
890 </div>
892 <div>
893 <div class='mark asterisk'> * </div>
894 <div class="field">
895 <input type="text" id="shippingAddress.postalCode" name="shippingAddress.postalCode" value="" style='width: 90px' maxlength='10' >
897 </div>
898 </div>
901 </div>
903 <div style="clear: both;"></div>
904 </div>
906 <div class="addressRowGroup">
908 <div class="addressRow">
909 <div class='mark asterisk'> &nbsp; </div>
910 <div class="field label">Country</div>
911 </div>
913 <div class="addressRow">
914 <div class='mark asterisk'> * </div>
915 <div class="field">
916 <select id="shippingAddress.country" name="shippingAddress.country" >
917 <option value="US"
919 >United States</option>
920 <option value="CA"
922 >Canada</option>
923 </select>
924 </div>
925 </div>
928 </div>
930 <div class="addressRowGroup">
932 <div class="addressRow">
933 <div class='mark asterisk'> &nbsp; </div>
934 <div class="field label">Contact Phone Number</div>
935 </div>
937 <div class="addressRow">
938 <div class='mark asterisk'> * </div>
939 <div class="field">
940 <input type="text" id="shippingAddress.phoneNumber" name="shippingAddress.phoneNumber" value="" maxlength='18' size='18' style='width: 120px;' >
942 </div>
943 </div>
944 <div class="addressRow">
945 <div class='mark asterisk'> &nbsp; </div>
946 <div class="field subNote">Used only for order inquiries</div>
947 </div>
950 </div>
952 </div>
953 </div>
954 </div>
957 <div id='restOfForm'>
959 <div class="yui-g">
961 <div class="yui-u first firstCol">
963 <a name="info"></a>
964 <div class="subHead"></span>Other Information</div>
966 <div class="addressRowGroup">
967 <div class="addressRow">
968 <div class='mark asterisk'> &nbsp; </div>
969 <div class="field label">
970 International Billing </div>
971 </div>
973 <div class="addressRow">
974 <div class='mark asterisk'> &nbsp; </div>
975 <div class="field">
976 <input type="text" id="customOrderHeader.internationalBilling" name="customOrderHeader.internationalBilling" value="" maxlength='50' style='width: 225px;' >
978 </div>
979 </div>
981 <div class="addressRow" style="width: 300px;">
982 <div class='mark asterisk'> &nbsp; </div>
983 <div class="field subNote">
984 Enter your country and phone number, with country code and city code. (max. 50 characters) </div>
985 </div>
986 </div>
988 <div class="addressRowGroup">
989 <div class="addressRow">
990 <div class='mark asterisk'> &nbsp; </div>
991 <div class="field label">
992 Salesperson Number </div>
993 </div>
995 <div class="addressRow">
996 <div class='mark asterisk'> &nbsp; </div>
997 <div class="field">
998 <input type="text" id="customOrderHeader.salespersonNumber" name="customOrderHeader.salespersonNumber" value="" maxlength='3' style='width: 30px;' >
1000 </div>
1001 </div>
1003 <div class="addressRow" style="width: 300px;">
1004 <div class='mark asterisk'> &nbsp; </div>
1005 <div class="field subNote">
1006 If you received help from a J&amp;R salesperson, please enter their number here. </div>
1007 </div>
1008 </div>
1010 </div>
1011 <div class="yui-u">
1013 <div class="subHead">
1014 Gift Options </div>
1016 <div class="addressRowGroup">
1017 <div class="addressRow">
1018 <div class='mark asterisk'> &nbsp; </div>
1019 <div class="field label">
1020 Gift From </div>
1021 </div>
1023 <div class="addressRow">
1024 <div class='mark asterisk'> &nbsp; </div>
1025 <div class="field">
1026 <input type="text" id="customOrderHeader.giftFromName" name="customOrderHeader.giftFromName" value="" style='width: 225px;' maxlength='30' >
1028 </div>
1029 </div>
1030 </div>
1034 <div class="addressRowGroup">
1035 <div class="addressRow">
1036 <div class='mark asterisk'> &nbsp; </div>
1037 <div class="field label">
1038 Gift Message </div>
1039 </div>
1041 <div class="addressRow">
1042 <div class='mark asterisk'> &nbsp; </div>
1043 <div class="field">
1044 <input type="text" id="customOrderHeader.giftMessage" name="customOrderHeader.giftMessage" value="" style='width: 225px;' maxlength='60' >
1046 </div>
1047 </div>
1049 <div class="addressRow">
1050 <div class='mark asterisk'> &nbsp; </div>
1051 <div class="field subNote">(max. 60 characters)</div>
1052 </div>
1055 <div class="addressRowGroup">
1056 <div class="addressRow">
1057 <div class='mark asterisk'> &nbsp; </div>
1058 <div class="field label">
1059 Gift Email </div>
1060 </div>
1062 <div class="addressRow">
1063 <div class='mark asterisk'> &nbsp; </div>
1064 <div class="field">
1065 <input type="text" id="customOrderHeader.giftEmailAddress" name="customOrderHeader.giftEmailAddress" value="" style='width: 225px;' maxlength='50' >
1067 </div>
1068 </div>
1070 <div class="addressRow">
1071 <div class='mark asterisk'> &nbsp; </div>
1072 <div class="field">
1074 target="giftnote"
1075 href="http://www.jr.com/information/pop_giftNotification.jsp">
1076 Learn more</a>
1077 </div>
1078 </div>
1079 </div>
1081 <div class="addressRowGroup">
1082 <div class="addressRow">
1083 <div class='mark asterisk'> &nbsp; </div>
1084 <input type="hidden" name="_customOrderHeader.giftHidePrices" value="false" />
1085 <input type="checkbox" id="customOrderHeader.giftHidePrices" name="customOrderHeader.giftHidePrices"
1089 <label for="customOrderHeader.giftHidePrices">Hide prices on the recipient's invoice and products on gift email.</label>
1090 </div>
1091 </div>
1093 </div>
1095 </div>
1096 </div>
1098 <style type="text/css">
1099 <!--
1100 div.orderSummaryRow {
1101 clear: both;
1102 margin-bottom: 15px;
1103 text-align: left;
1105 div.orderSummaryLeft {
1106 float: left;
1107 width: 50px;
1108 font-weight: bold;
1109 text-align: left;
1111 div.orderSummaryRight {
1112 margin-left: 55px;
1113 text-align: right;
1114 font-weight: bold;
1117 </style>
1120 <div class="subHead">In Your Cart</div>
1122 <div class="yui-ge">
1123 <div class="yui-u first">
1124 <div class="cartDetailHeader">
1125 <table align="center" bgcolor="#ffffff" cellpadding="0" cellspacing="0" width="95%">
1126 <tr>
1127 <td align="left">
1128 <b>Item Description</b>
1129 </td>
1130 <td align="right" width="80">
1131 <b>Price</b>
1132 </td>
1133 <td align="center" width="75">
1134 <b>Quantity</b>
1135 </td>
1136 <td align="right" width="90">
1137 <b>Total</b>
1138 </td>
1139 </tr>
1140 </table>
1141 </div>
1143 <table id="cartDetailTab" align="center" bgcolor="#ffffff" cellpadding="0" cellspacing="0" width="95%">
1144 <tr>
1145 <td cellpadding="0" cellspacing="0" align="left" valign="top">
1146 <div style="padding: 0px;">
1147 Panasonic Lumix DMC-LX5 10.1 Megapixel Digital Camera - Black
1148 </div>
1149 <div class="productItemMessage" style="font-style:italic;">
1151 </div>
1152 </td>
1153 <td cellspacing="0" cellpadding="0" align="right" valign="top" width="80">
1154 $499.95
1155 </td>
1156 <td cellspacing="0" cellpadding="0" align="center" valign="top" width="75">
1158 </td>
1159 <td cellspacing="0" cellpadding="0" align="right" valign="top" width="90">
1160 <div class="fontItemPrice">
1161 $499.95
1162 </div>
1163 &nbsp;
1164 </td>
1165 </tr>
1167 <tr>
1168 <td colspan="4" valign="bottom">
1169 <div class="productItemMessage">Buy this Camera Save $5 off select memory cards. <a href="/promotion/listContent.jsp?promoName=MemCard" ><b> See Details</b></a></div>
1170 </td>
1171 </tr>
1173 <tr>
1174 <td colspan="4" valign="bottom">
1175 <div style="margin: 0 0 2px 315px; text-align: left;">
1176 <span class="fontsmall" style="margin-left: 5px;">&nbsp;</span>
1177 </div>
1178 </td>
1179 </tr>
1180 <tr><td colspan="4" style="padding: 0px 0px 5px;"><div style="background-image: url(/media/images/dotted_horiz_v1_m56577569831605050.gif); height: 1px;"><img src="#" alt="" border="0" height="1" width="212"></div></td></tr>
1181 </table>
1182 <div class="stepsWarning">
1183 (You may go back to the
1184 <a href="/checkout.flow?_flowExecutionKey=_c1CD2F5A1-28EE-6B0F-71FC-DCDBE4BCCA78_k64250CE6-ADB4-BD9D-FEED-2C51C69CE671&_eventId=cancelOrder">Shopping Cart</a>
1185 to change your selections.)
1186 </div>
1188 </div>
1190 <div class="yui-u">
1194 <div class="refinements jrui-center">Order Summary</div>
1196 <div class="orderSummaryBox">
1197 <div class="orderSummaryRow">
1198 <div class="orderSummaryLeft largerFont">Subtotal:</div>
1199 <div class="orderSummaryRight largerFont">$499.95</div>
1200 </div>
1202 <div class="orderSummaryRow">
1203 Shipping charge and total will be displayed once you select your shipping option later in the process. </div>
1206 <div class="orderSummaryRow">
1207 <div class="orderSummaryLeft">Tax:</div>
1208 <div class="orderSummaryRight">
1209 NY Only* </div>
1210 </div>
1212 <div class="orderSummaryRow">
1213 *J&amp;R only collects local sales tax on orders shipped to NY State. </div>
1215 <div class="orderSummaryRow" style="text-align: center;">
1216 <input type="image" name="_eventId_continue" value="submit" alt="Continue" src="#" />
1217 </div>
1219 </div>
1221 </div>
1223 </div>
1224 </form>
1230 </body>
1231 </html>