<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//code.jquery.com/jquery-1.11.1.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class='container'> <div class='row' style='padding-top:25px; padding-bottom:25px;'> <div class='col-md-12'> <div id='mainContentWrapper'> <div class="col-md-8 col-md-offset-2"> <h2 style="text-align: center;"> Review Your Order & Complete Checkout </h2> <hr/> <a href="#" class="btn btn-info" style="width: 100%;">Add More Products & Services</a> <hr/> <div class="shopping_cart"> <form class="form-horizontal" role="form" action="" method="post" id="payment-form"> <div class="panel-group" id="accordion"> <div class="panel panel-default"> <div class="panel-heading"> <h4 class="panel-title"> <a data-toggle="collapse" data-parent="#accordion" href="#collapseOne">Review Your Order</a> </h4> </div> <div id="collapseOne" class="panel-collapse collapse in"> <div class="panel-body"> <div class="items"> <div class="col-md-9"> <table class="table table-striped"> <tr> <td colspan="2"> <a class="btn btn-warning btn-sm pull-right" href="http://www.startajobboard.com/" title="Remove Item">X</a> <b> Premium Posting</b></td> </tr> <tr> <td> <ul> <li>One Job Posting Credit</li> <li>Job Distribution*</li> <li>Social Media Distribution</li> </ul> </td> <td> <b>$147.00</b> </td> </tr> </table> </div> <div class="col-md-3"> <div style="text-align: center;"> <h3>Order Total</h3> <h3><span style="color:green;">$147.00</span></h3> </div> </div> </div> </div> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"> <h4 class="panel-title"> <div style="text-align: center; width:100%;"><a style="width:100%;" data-toggle="collapse" data-parent="#accordion" href="#collapseTwo" class=" btn btn-success" onclick="$(this).fadeOut(); $('#payInfo').fadeIn();">Continue to Billing Information»</a></div> </h4> </div> </div> <div class="panel panel-default"> <div class="panel-heading"> <h4 class="panel-title"> <a data-toggle="collapse" data-parent="#accordion" href="#collapseTwo">Contact and Billing Information</a> </h4> </div> <div id="collapseTwo" class="panel-collapse collapse"> <div class="panel-body"> <b>Help us keep your account safe and secure, please verify your billing information.</b> <br/><br/> <table class="table table-striped" style="font-weight: bold;"> <tr> <td style="width: 175px;"> <label for="id_email">Best Email:</label></td> <td> <input class="form-control" id="id_email" name="email" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_first_name">First name:</label></td> <td> <input class="form-control" id="id_first_name" name="first_name" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_last_name">Last name:</label></td> <td> <input class="form-control" id="id_last_name" name="last_name" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_address_line_1">Address:</label></td> <td> <input class="form-control" id="id_address_line_1" name="address_line_1" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_address_line_2">Unit / Suite #:</label></td> <td> <input class="form-control" id="id_address_line_2" name="address_line_2" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_city">City:</label></td> <td> <input class="form-control" id="id_city" name="city" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_state">State:</label></td> <td> <select class="form-control" id="id_state" name="state"> <option value="AK">Alaska</option> <option value="AL">Alabama</option> <option value="AZ">Arizona</option> <option value="AR">Arkansas</option> <option value="CA">California</option> <option value="CO">Colorado</option> <option value="CT">Connecticut</option> <option value="DE">Delaware</option> <option value="FL">Florida</option> <option value="GA">Georgia</option> <option value="HI">Hawaii</option> <option value="ID">Idaho</option> <option value="IL">Illinois</option> <option value="IN">Indiana</option> <option value="IA">Iowa</option> <option value="KS">Kansas</option> <option value="KY">Kentucky</option> <option value="LA">Louisiana</option> <option value="ME">Maine</option> <option value="MD">Maryland</option> <option value="MA">Massachusetts</option> <option value="MI">Michigan</option> <option value="MN">Minnesota</option> <option value="MS">Mississippi</option> <option value="MO">Missouri</option> <option value="MT">Montana</option> <option value="NE">Nebraska</option> <option value="NV">Nevada</option> <option value="NH">New Hampshire</option> <option value="NJ">New Jersey</option> <option value="NM">New Mexico</option> <option value="NY">New York</option> <option value="NC">North Carolina</option> <option value="ND">North Dakota</option> <option value="OH">Ohio</option> <option value="OK">Oklahoma</option> <option value="OR">Oregon</option> <option value="PA">Pennsylvania</option> <option value="RI">Rhode Island</option> <option value="SC">South Carolina</option> <option value="SD">South Dakota</option> <option value="TN">Tennessee</option> <option value="TX">Texas</option> <option value="UT">Utah</option> <option value="VT">Vermont</option> <option value="VA">Virginia</option> <option value="WA">Washington</option> <option value="DC">Washington D.C.</option> <option value="WV">West Virginia</option> <option value="WI">Wisconsin</option> <option value="WY">Wyoming</option> </select> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_postalcode">Postalcode:</label></td> <td> <input class="form-control" id="id_postalcode" name="postalcode" required="required" type="text"/> </td> </tr> <tr> <td style="width: 175px;"> <label for="id_phone">Phone:</label></td> <td> <input class="form-control" id="id_phone" name="phone" type="text"/> </td> </tr> </table> </div> </div> </div> <div class="panel panel-default"> <div class="panel-heading"> <h4 class="panel-title"> <div style="text-align: center;"><a data-toggle="collapse" data-parent="#accordion" href="#collapseThree" class=" btn btn-success" id="payInfo" style="width:100%;display: none;" onclick="$(this).fadeOut(); document.getElementById('collapseThree').scrollIntoView()">Enter Payment Information »</a> </div> </h4> </div> </div> <div class="panel panel-default"> <div class="panel-heading"> <h4 class="panel-title"> <a data-toggle="collapse" data-parent="#accordion" href="#collapseThree"> <b>Payment Information</b> </a> </h4> </div> <div id="collapseThree" class="panel-collapse collapse"> <div class="panel-body"> <span class='payment-errors'></span> <fieldset> <legend>What method would you like to pay with today?</legend> <div class="form-group"> <label class="col-sm-3 control-label" for="card-holder-name">Name on Card</label> <div class="col-sm-9"> <input type="text" class="form-control" stripe-data="name" id="name-on-card" placeholder="Card Holder's Name"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label" for="card-number">Card Number</label> <div class="col-sm-9"> <input type="text" class="form-control" stripe-data="number" id="card-number" placeholder="Debit/Credit Card Number"> <br/> <div><img class="pull-right" src="https://s3.amazonaws.com/hiresnetwork/imgs/cc.png" style="max-width: 250px; padding-bottom: 20px;"> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label" for="expiry-month">Expiration Date</label> <div class="col-sm-9"> <div class="row"> <div class="col-xs-3"> <select class="form-control col-sm-2" data-stripe="exp-month" id="card-exp-month" style="margin-left:5px;"> <option>Month</option> <option value="01">Jan (01)</option> <option value="02">Feb (02)</option> <option value="03">Mar (03)</option> <option value="04">Apr (04)</option> <option value="05">May (05)</option> <option value="06">June (06)</option> <option value="07">July (07)</option> <option value="08">Aug (08)</option> <option value="09">Sep (09)</option> <option value="10">Oct (10)</option> <option value="11">Nov (11)</option> <option value="12">Dec (12)</option> </select> </div> <div class="col-xs-3"> <select class="form-control" data-stripe="exp-year" id="card-exp-year"> <option value="2016">2016</option> <option value="2017">2017</option> <option value="2018">2018</option> <option value="2019">2019</option> <option value="2020">2020</option> <option value="2021">2021</option> <option value="2022">2022</option> <option value="2023">2023</option> <option value="2024">2024</option> </select> </div> </div> </div> </div> <div class="form-group"> <label class="col-sm-3 control-label" for="cvv">Card CVC</label> <div class="col-sm-3"> <input type="text" class="form-control" stripe-data="cvc" id="card-cvc" placeholder="Security Code"> </div> </div> <div class="form-group"> <div class="col-sm-offset-3 col-sm-9"> </div> </div> </fieldset> <button type="submit" class="btn btn-success btn-lg" style="width:100%;">Pay Now </button> <br/> <div style="text-align: left;"><br/> By submiting this order you are agreeing to our <a href="/legal/billing/">universal billing agreement</a>, and <a href="/legal/terms/">terms of service</a>. If you have any questions about our products or services please contact us before placing this order. </div> </div> </div> </div> </div> </div> </form> </div> </div> </div>