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[MM_Form type=’checkout’] [MM_Form_Message type=’error’]

[MM_Form_Section type=’accountInfo’]

Account Information

[MM_Form_Field type=’custom’ id=’28’ isRequired=’true’ customAttributes=’placeholder=”Company Name”‘ ]


[MM_Form_Field type=’custom-hidden’ id=’46’ isRequired=’false’ class=” value=’Orange Envelope’]

[MM_Form_Field type=’input’ name=’firstName’ isRequired=’true’ customAttributes=’placeholder=”First Name”‘]

[MM_Form_Field type=’input’ name=’lastName’ isRequired=’true’ customAttributes=’placeholder=”Last Name”‘]

[MM_Form_Field type=’input’ name=’email’ isRequired=’true’ customAttributes=’placeholder=”Email Address”‘]

[MM_Form_Field type=’input’ name=’phone’ isRequired=’false’ customAttributes=’placeholder=”Phone Number”‘]

[MM_Form_Field type=’input’ name=’password’ customAttributes=’placeholder=”Password”‘]

[/MM_Form_Section] [MM_Form_Section type=’billingInfo’]

Billing Details

Visa, Master Card, American Express, Discover

[MM_Form_Field name=’ccNumber’ customAttributes=’placeholder=”Credit Card Number”‘]

[MM_Form_Field name=’ccExpirationDate’]

[MM_Form_Field name=’ccSecurityCode’ customAttributes=’placeholder=”Security Code”‘]

Billing Address

[MM_Form_Field name=’billingAddress’ customAttributes=’placeholder=”Billing Address”‘]

[MM_Form_Field name=’billingCity’ customAttributes=’placeholder=”Billing City”‘]

[MM_Form_Field name=’billingState’ customAttributes=’placeholder=”Billing Province”‘]

[MM_Form_Field name=’billingZipCode’ customAttributes=’placeholder=”Billing Postal Code”‘]

[MM_Form_Field name=’billingCountry’]

[/MM_Form_Section]

[MM_Form_Button type=’all’ label=’Submit Order’ color=’orange’]

 

[MM_Form_Data name=’productName’ useAccessName=’false’]

[MM_Form_Data name=’productDescription’]

    • Product Price: [MM_Form_Data name=’productPriceDescription’]
  • Total Price: [MM_Form_Data name=’totalPrice’]

[/MM_Form]