<?PHP
echo("
<form action='".$PHP_SELF."' method='POST'> 
<input type='hidden' name='sid' value='".trim($sid)."'>
<input type='hidden' name='whm_id' value='".trim($whm_id)."'>
".((isset($uid))?"<input type='hidden' name='uid' value='".trim($uid)."'>":"")."
".((isset($oid))?"<input type='hidden' name='oid' value='".trim($oid)."'>":"")."
".((isset($resell))?"<input type='hidden' name='resell' value='".trim($resell)."'>":"")."
<input type='hidden' name='seconds' value='".trim($seconds)."'>
<table width='725' cellpadding='2' cellspacing='0' border='0'>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'><b>This account is on:</b></td>
		<td width='70%' align='left' valign='top'><font color='#990000'><b>".$server_name."</b></font></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Define WHM Logins:</td>
		<td width='70%' align='left' valign='top'>cPanel Username: <input ".$input_style." type='text' name='whm_username' size='18' maxlength='8' value='".((isset($whm_username))?"".trim($whm_username)."":"")."'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'></td>
		<td width='75%' align='left' valign='top'>cPanel Password: <input ".$input_style." type='text' name='whm_password' size='18' maxlength='32' value='".((isset($whm_password))?"".trim($whm_password)."":"")."'></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='6'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/".((isset($err0))?"error_arrow.gif":"space.gif")."' width='15' height='9'>Domain Name:</td>
		<td width='70%' align='left' valign='top'><font size='1'>http://www.</font><input ".$input_style." size='33' maxlength='255' type='text' name='domain_name' value='".((isset($domain_name))?"".trim(stripslashes($domain_name))."":"")."'></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
		<tr>
			<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>IP Address:</td>
			<td width='70%' align='left' valign='top'><input ".$input_style." size='43' maxlength='255' type='text' name='ip' value='".trim($ip)."'></td>
		</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
		<tr>
			<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Primary NS:</td>
			<td width='70%' align='left' valign='top'><input ".$input_style." size='43' maxlength='255' type='text' name='ns1' value='".trim($ns1)."'></td>
		</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
		<tr>
			<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Secondary NS:</td>
			<td width='70%' align='left' valign='top'><input ".$input_style." size='43' maxlength='255' type='text' name='ns2' value='".trim($ns2)."'></td>
		</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Domain Expires:</td>
		<td width='70%' align='left' valign='top'><input ".$input_style." name='dexpirem' type='text' size='2' maxlength='2' value='".((isset($dexpirem))?"".$dexpirem."":"")."'> / <input ".$input_style." name='dexpired' type='text' size='2' maxlength='2' value='".((isset($dexpired))?"".$dexpired."":"")."'> / <input ".$input_style." name='dexpirey' type='text' size='4' maxlength='4' value='".((isset($dexpirey))?"".$dexpirey."":"")."'> ex. MM/DD/YYYY</td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Is this domain resolved?</td>
		<td width='70%' align='left' valign='top'><input type='checkbox' name='resolved' value='1'".((isset($resolved))?"".(($resolved==1)?" checked":"")."":" checked")."> Check here to mark as resolved.</td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<!--- <tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Choose a Server:</td>
		<td width='70%' align='left' valign='top'><select name='whm_id' ".$input_style.">
	");
$row1=mysql_query("select whm_id, server_name from server_config order by server_name asc");
while ($rs1=mysql_fetch_row($row1))
	{
	echo"<option value='".$rs1[0]."'".((isset($whm_id))?"".(($whm_id==$rs1[0])?" selected":"")."":"").">".$rs1[1]."</option>\n";
	}
echo("
		</select></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr> --->
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Choose Hosting Package:</td>
		<td width='70%' align='left' valign='top'><select name='pid' ".$input_style.">
	");
$row2=mysql_query("select pid, package_name, monthly_cost, quarterly_cost, semi_annual_cost, annual_cost from plan_specs order by package_name asc");
while ($rs2=mysql_fetch_row($row2))
	{
	echo"<option value='".$rs2[0]."|monthly'".((isset($pid))?"".(($pid==$rs2[0]."|monthly")?" selected":"")."":"").">".$rs2[1]." - ".$rs2[2]." Monthly</option>\n";
	echo"<option value='".$rs2[0]."|quarterly'".((isset($pid))?"".(($pid==$rs2[0]."|quarterly")?" selected":"")."":"").">".$rs2[1]." - ".$rs2[3]." Quarterly</option>\n";
	echo"<option value='".$rs2[0]."|semi_annual'".((isset($pid))?"".(($pid==$rs2[0]."|semi_annual")?" selected":"")."":"").">".$rs2[1]." - ".$rs2[4]." Semi-Annually</option>\n";
	echo"<option value='".$rs2[0]."|annual'".((isset($pid))?"".(($pid==$rs2[0]."|annual")?" selected":"")."":"").">".$rs2[1]." - ".$rs2[5]." Annually</option>\n";
	}
echo("
		</select></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Next Due Date:</td>
		<td width='70%' align='left' valign='top'><input ".$input_style." name='next_due_date' type='text' size='16' maxlength='25' value='".((isset($next_due_date))?"".$next_due_date."":"")."'> ex. MM/DD/YYYY</td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Account Created on:</td>
		<td width='70%' align='left' valign='top'><input ".$input_style." name='build_date' type='text' size='16' maxlength='25' value='".((isset($build_date))?"".$build_date."":"")."'> ex. MM/DD/YYYY</td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='2'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'><img src='".$http_images."/space.gif' width='15' height='9'>Choose Payment Type:</td>
		<td width='70%' align='left' valign='top'>
		<select name='payment_method' ".$input_style.">
	");
$rspmx=mysql_query("select pid, name from payment_process order by name asc");
while($rspm=mysql_fetch_row($rspmx))
	{
	echo"<option value='".$rspm[0]."'".(($payment_method==$rspm[0])?" selected":"").">".$rspm[1]."</option>\n";
	}
echo("
		</select></td>
	</tr>
	<tr>
		<td colspan='2'><img src='".$http_images."/space.gif' width='1' height='12'></td>
	</tr>
	<tr>
		<td width='30%' align='left' valign='top'></td>
		<td width='70%' align='left' valign='top'><input ".$button_style." type='submit' name='submity' value='Create Account Information &gt&gt'></td>
	</tr>
</table>
</form>
	");
		
?>