<?php
$page_title = "Deposit  Application";
include_once('template/base_head.php');
?>
			<!-- サイドバー -->
			<aside id="colLeft">
				<h1><a href="/ja/menu"><img src="../img/logo.png" alt="iWallet"></a></h1>
<?php include_once('template/base_sidebar.php'); ?>
			</aside>
			<!-- /サイドバー -->
			<!-- メインカラム -->
			<div id="colMain">
				<div class="mainIn">
<?php include_once('template/base_nav.php'); ?>
					<article>
						<div class="article-heading">
							<h2><?php echo $page_title; ?></h2>
						</div>
						<form id="acForm" action="http://api.iwl.world/Forwarder_Gpaysafe" method="post">
							<p class="pleft40 mb20 respM">The voucher purchased will be reflected to your iWallet account.</p>

							<table class="table col bdr default odd transferT fontM mb20 ma90sp">
								<tr>
									<th>Payment Type</th>
									<td><?php $this -> echoMethodString(); ?></td>
								</tr>
								<tr>
									<th>Credit Amount(Amount Reflect to Account)</th>
									<td><?php echo VAR_GPAYSAFE_CARD_CURRENCY ?> <?php $this -> dispAmount(); ?></td>
								</tr>
								<tr>
									<th>Amount to Pay (Price of Voucher)</th>
									<td><?php echo $this -> dispCurrency(); ?> <?php $this -> dispPayment(); ?></td>
								</tr>
							</table>
							<table class="table col bdr default odd transferT fontM mb40 ma90sp">
								<tr>
									<th colspan="2">Purchaser Details</th>
								</tr>
								<tr>
									<th>Email Address</th>
									<td><?php $this -> echoUserData(PARAM_MAIL); ?></td>
								</tr>
								<tr>
									<th>Full Name</th>
									<td><?php $this -> echoUserData(PARAM_FIRST_NAME); ?>&nbsp;<?php $this -> echoUserData(PARAM_LAST_NAME); ?></td>
								</tr>
								<tr>
									<th>Date of Birth</th>
									<td><?php $this -> echoUserData(PARAM_BIRTH_STRING); ?></td>
								</tr>
								<tr>
									<th>Residence Country</th>
									<td><?php $this -> echoCountryName(); ?></td>
								</tr>
								<tr>
									<th>State</th>
									<td><?php $this -> echoUserData(PARAM_STATE); ?></td>
								</tr>
								<tr>
									<th>City</th>
									<td><?php $this -> echoUserData(PARAM_CITY); ?></td>
								</tr>
								<tr>
									<th>Address</th>
									<td><?php $this -> echoUserData(PARAM_ADDRESS); ?></td>
								</tr>
								<tr>
									<th>Post Code</th>
									<td><?php $this -> echoUserData(PARAM_ZIP_CODE); ?></td>
								</tr>
								<tr>
									<th>Phone Number</th>
									<td><?php $this -> echoUserData(PARAM_TEL); ?></td>
								</tr>
							</table>
							<p class="transferButton mb30">
								<strong><?php echo $this -> dispCurrency(); ?> <?php $this -> dispPayment(); ?> of vouchers purchased will be reflected to your iWallet account with the amount of <?php echo VAR_GPAYSAFE_CARD_CURRENCY ?> <?php $this -> dispAmount(); ?>. </strong><br/>
								Please move forward to the next page to complete the payment.
							</p>

							<p class="transferButton mb30">
								<a id="btnBackInput" class="btn bg-default calign">&laquo; Go Back</a>&emsp;
								<input type="button" id="btnGoGps" value="Go to Payment Page" class="btn bg-grad px180 calign">
							</p>

							<p class="red pleft40">
								【※Notes】<br/>
								・Please purchase vouchers using the Visa Card under the name of yourself (the account holder). <br/>
								・The purchase statement will display the service name and beneficiary account for your credit card as「<?php $this -> echoInvoiceName(); ?>」.<br/>
								・Chargeback is not available due the nature of this service. <br/>
								・ <?php $this -> echoDailyCountLimit(); ?>times maximum for voucher purchasing per day.<br/>
								・The maximum purchasing amount during <?php $this -> echoBetweenDate(); ?> days is €<?php $this -> echoAmountLimit(); ?><br/>
							</p>

							<input type="hidden" value="" id="type" name="type" />
							<input type="hidden" value="<?php $this -> echoMethod(); ?>" id="method" name="method" />
							<input type="hidden" value="<?php $this -> echoAmount(); ?>" id="amount" name="amount" />
							<input type="hidden" value="<?php $this -> echoPayment(); ?>" id="payment" name="payment" />
							<input type="hidden" value="<?php $this -> dispCurrency(); ?>" id="currency" name="currency" />
							<input type="hidden" value="<?php $this -> echoAccount(); ?>" id="user_account" name="user_account" />
							<input type="hidden" value="<?php echo $this -> getLangage(); ?>" id="language" name="language" />
						</form>
					</article>
				</div>
			</div>
			<!-- /メインカラム -->
		</div>
<?php include_once('template/base_foot.php'); ?>
	</div>
	<script src="../js/deposit.js"></script>
</body>
</html>
