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- <html>
- <body>
- <form method="post" action="form.php">
- Full Name: <input type="text" name="FullName" value="
- Notice: Undefined index: FullName in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 38
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 38
- "><br />
- Phone :<input type="text" name="Phone" value="
- Notice: Undefined index: Phone in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 42
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 42
- " empty="yes"><br />
- Exp Date: <input type="text" name="CCExpDate" size="8" value="
- Notice: Undefined index: CCExpDate in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 46
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 46
- "><br />
- Email: <input type="text" name="Email" size="30" value="
- Notice: Undefined index: Email in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 50
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 50
- "><br />
- Date: <input type="text" name="Date" size="10" value="
- Notice: Undefined index: Date in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 54
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 54
- "><br />
- password: <input type="password" name="password" size="10" value="
- Notice: Undefined index: password in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 58
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 58
- "><br />
- password2: <input type="password" name="password2" size="10" value="
- Notice: Undefined index: password2 in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 60
- Notice: Trying to get property of non-object in C:\Smarty\smarty_templates_c\fad0dc380a6f7f778f40a72ef7e4f3acee579c20.file.form.tpl.php on line 60
- "><br />
- <input type="submit">
- </form>
- </body>
- </html>
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