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1 forms found in the DOM

POST thanks.php

<form novalidate="" method="post" action="thanks.php" id="theForm">
  <input type="hidden" name="conversion" id="conversion" value="0.80">
  <input type="hidden" name="vtoken" id="vtoken" value="">
  <input type="hidden" name="theAmount" id="theAmount" value="">
  <h1>Payment Details</h1>
  <p>Please enter the payment details below:</p>
  <p>Please complete your cardholder billing details below. Payments are immediate. At no time are any credit card details stored within this website.</p>
  <p><strong>NOTE: This transaction will show as SQ *BEN JAMIESON PHOTOGR on your statement.</strong></p>
  <div class="sq-field">
    <label class="sq-label">Company</label>
    <input type="text" name="order-description" id="order-description" value="" required="">
  </div>
  <div class="sq-field">
    <label class="sq-label">Invoice Number</label>
    <input type="text" name="order-id" id="order-id" value="" required="">
  </div>
  <div class="sq-field">
    <label class="sq-label">Amount</label>
    <input type="text" name="amount" id="amount" value="" placeholder="Example: 1000" required=""> (do not include $ symbol or commas)
  </div>
  <div class="sq-field-wrapper">
    <div class="sq-field sq-field--in-wrapper">
      <label class="sq-label">First Name on Card</label>
      <input type="text" name="givenName" id="givenName" required="">
    </div>
    <div class="sq-field sq-field--in-wrapper">
      <label class="sq-label">Last Name on Card</label>
      <input type="text" name="familyName" id="familyName" required="">
    </div>
  </div>
  <div class="sq-field">
    <label class="sq-label">Address/PO Box</label>
    <input type="text" name="address1" id="address1" required="">
  </div>
  <div class="sq-field-wrapper">
    <div class="sq-field sq-field--in-wrapper">
      <label class="sq-label">City/Settlement</label>
      <input type="text" name="city" id="city" required="">
    </div>
    <div class="sq-field sq-field--in-wrapper">
      <label class="sq-label">Country (ISO Two Letter Code - Bahamas is 'BS', USA is 'US', Canada is 'CA')</label>
      <input type="text" name="country" id="country" required="" maxlength="2" value="BS">
    </div>
  </div>
  <div class="sq-field">
    <label class="sq-label">Email</label>
    <input type="email" name="email" id="email" required="">
  </div>
  <div class="sq-field">
    <label class="sq-label">Card Details</label>
    <div id="card-container">
      <div id="single-card-wrapper-86b0c68f-d6ee-8e96-f87e-426e76817e69" class="sq-card-wrapper">
        <div class="sq-card-iframe-container" style="height: 48px;"><iframe frameborder="0" height="48px" name="single-card-86b0c68f-d6ee-8e96-f87e-426e76817e69" scrolling="no" src="https://web.squarecdn.com/1.51.4/single-card-element-iframe.html"
            width="100%" class="sq-card-component"></iframe></div><span class="sq-card-message"></span>
      </div>
    </div>
    <button id="card-button" type="button">Make Payment</button>
    <span id="payment-flow-message"></span>
  </div>
</form>

Text Content

PAYMENT DETAILS

Please enter the payment details below:

Please complete your cardholder billing details below. Payments are immediate.
At no time are any credit card details stored within this website.

NOTE: This transaction will show as SQ *BEN JAMIESON PHOTOGR on your statement.

Company
Invoice Number
Amount (do not include $ symbol or commas)
First Name on Card
Last Name on Card
Address/PO Box
City/Settlement
Country (ISO Two Letter Code - Bahamas is 'BS', USA is 'US', Canada is 'CA')
Email
Card Details

Make Payment

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