Untitled

<!DOCTYPE html>
<html lang="en">
<head>
    <meta charset="UTF-8">

  <title>Charge</title>
</head>
<body>

<form action="charge.php/?id=4" method="POST" id="payment-form">
<table>
    <tr>
        <td>Name: </td>
        <td><input id="name" type="text"></td>
    </tr>
    <tr>
        <td>Email: </td>
        <td><input id="email" type="text"></td>
    </tr>
    <tr>
        <td>Credit Card Number: </td>
        <td><input id="cc-number" type="text"></td>
    </tr>
    <tr>
        <td>Expiration Month: </td>
        <td><input id="cc-month" type="text"></td>
    </tr>
    <tr>
        <td>Expiration Year: </td>
        <td><input id="cc-year" type="text"></td>
    </tr>
    <tr>
        <td>CVV: </td>
        <td><input id="cc-cvv" type="text"></td>
    </tr>
    <tr>
        <td>Postal Code: </td>
        <td><input id="postal_code" type="text"></td>
    </tr>
    <tr>
        <td></td>
        <td><input type="submit" class="submit" value="Submit Payment"></td>
    </tr>
</table>
 </form>
<script src="https://ajax.googleapis.com/ajax/libs/jquery/1.12.4/jquery.min.js"></script>
<script type="text/javascript" src="https://static.wepay.com/min/js/tokenization.v2.js"></script>
<script>
	$(function() {
		WePay.set_endpoint("production");
		var client_id = 184547;
	      var $form = $('#payment-form');
	       var d = document;
	        d.id = d.getElementById,
	        valueById = function(id) {
	            return d.id(id).value;
	        };
	      $form.submit(function(event) {
	        // Disable the submit button to prevent repeated clicks:
	        $form.find('.submit').prop('disabled', true);

	        // Request a token from Stripe:
	        response = WePay.credit_card.create({
		    "client_id":        client_id,
		    "user_name":        valueById('name'),
		    "email":            valueById('email'),
		    "cc_number":        valueById('cc-number'),
		    "cvv":              valueById('cc-cvv'),
		    "expiration_month": valueById('cc-month'),
		    "expiration_year":  valueById('cc-year'),
		    "address": {
		        "postal_code": valueById('postal_code')
		    }
		}, function(data) {


		    if (data.error) {
		        console.log(data);

		    } else {
		     	console.log(data.credit_card_id);
		        // call your own app's API to save the token inside the data;
		        // show a success page

		        var $form = $('#payment-form');
		        var $token = data.credit_card_id;
		        $form.append($('<input type="hidden" name="wepayToken">').val($token));
		        $form.get(0).submit();

		    }
		});

	        // Prevent the form from being submitted:
	        return false;
	      });
	    });


</script>


</body>
</html>