s-bands.centralbank.net Open in urlscan Pro
199.255.162.70  Public Scan

Form analysis
1 forms found in the DOM

POST https://central.electpay.net/OnlinePayments/GenericV1/CreatePayment

<form id="MyForm" class="needs-validation form" method="post" novalidate="" action="https://central.electpay.net/OnlinePayments/GenericV1/CreatePayment">
  <div id="step1">
    <!-- Step Counter -->
    <ol class="step-counter">
      <li class="step-active">Customer Info</li>
      <li>Payment Details</li>
    </ol>
    <hr>
    <p id="currentStep" class="small">Step 1 of 2</p>
    <!-- Customer Info Header -->
    <h2 class="form-header">Customer Information</h2>
    <!-- Form Fields -->
    <div class="row">
      <!-- Student Name -->
      <div class="form-field col-sm-12 mt-3">
        <div id="divsn">
          <label class="input-label" for="studentName">Student's Full Name</label>
          <div class="input-wrapper">
            <input type="text" id="studentName" class="input-text" autofocus="autofocus" required="">
          </div>
          <span class="invisible error-message">Please enter the student's name.</span>
        </div>
      </div>
    </div>
    <div class="row">
      <!-- First Name-->
      <div class="form-field col-sm-6">
        <div id="divf">
          <label class="input-label" for="firstName">Parent's First Name</label>
          <div class="input-wrapper">
            <input type="text" id="firstName" class="input-text" required="">
          </div>
          <span class="invisible error-message">Please enter your first name.</span>
        </div>
      </div>
      <!-- Last Name-->
      <div class="form-field col-sm-6">
        <div id="divl">
          <label class="input-label" for="lastName">Parent's Last Name</label>
          <div class="input-wrapper">
            <input type="text" id="lastName" class="input-text" required="">
          </div>
          <span class="invisible error-message">Please enter your last name.</span>
        </div>
      </div>
    </div>
    <div class="row">
      <!-- Street Address -->
      <div class="form-field col-sm-12">
        <div id="divsa">
          <label class="input-label" for="streetAddress">Street Address</label>
          <div class="input-wrapper">
            <input type="text" id="streetAddress" class="input-text" required="">
          </div>
          <span class="invisible error-message">Please enter the street address.</span>
        </div>
      </div>
    </div>
    <div class="row">
      <!-- City -->
      <div class="form-field col-sm-5">
        <div id="divc">
          <label class="input-label" for="city">City</label>
          <div class="input-wrapper">
            <input type="text" id="city" class="input-text" required="">
          </div>
          <span class="invisible error-message">Please enter the city name.</span>
        </div>
      </div>
      <!-- State -->
      <div class="form-field col-sm-3">
        <div id="divs">
          <label class="input-label" for="state">State</label>
          <div class="input-wrapper dropdown-wrapper">
            <select id="state" class="input-dropdown" placeholder="" required="">
              <option value="Alabama">AL</option>
              <option value="Alaska">AK</option>
              <option value="Arizona">AZ</option>
              <option value="Arkansas">AR</option>
              <option value="California">CA</option>
              <option value="Colorado">CO</option>
              <option value="Connecticut">CT</option>
              <option value="Deleware">DE</option>
              <option value="Florida">FL</option>
              <option value="Georgia">GA</option>
              <option value="Hawaii">HI</option>
              <option value="Idaho">ID</option>
              <option value="Illinois">IL</option>
              <option value="Indiana">IN</option>
              <option value="Iowa">IA</option>
              <option value="Kansas">KS</option>
              <option value="Kentucky">KY</option>
              <option value="Louisiana">LA</option>
              <option value="Maine">ME</option>
              <option value="Maryland">MD</option>
              <option value="Massachusetts">MA</option>
              <option value="Michigan">MI</option>
              <option value="Minnesota">MN</option>
              <option value="Mississippi">MS</option>
              <option value="Missouri" selected="">MO</option>
              <option value="Montana">MT</option>
              <option value="Nebraska">NE</option>
              <option value="Nevada">NV</option>
              <option value="New Hampshire">NH</option>
              <option value="New Jersey">NJ</option>
              <option value="New Mexico">NM</option>
              <option value="New York">NY</option>
              <option value="North Carolina">NC</option>
              <option value="North Dakota">ND</option>
              <option value="Ohio">OH</option>
              <option value="Oklahoma">OK</option>
              <option value="Oregon">OR</option>
              <option value="Pennsylvania">PA</option>
              <option value="Rhode Island">RI</option>
              <option value="South Carolina">SC</option>
              <option value="South Dakota">SD</option>
              <option value="Tennessee">TN</option>
              <option value="Texas">TX</option>
              <option value="Utah">UT</option>
              <option value="Vermont">VT</option>
              <option value="Virginia">VA</option>
              <option value="Washington">WA</option>
              <option value="West Virginia">WV</option>
              <option value="Wisconsin">WI</option>
              <option value="Wyoming">WY</option>
            </select>
          </div>
          <span class="invisible error-message">Please enter a valid state.</span>
        </div>
      </div>
      <!-- Zip Code -->
      <div class="form-field col-sm-4">
        <div id="divz">
          <label class="input-label" for="zipCode">Zip Code</label>
          <div class="input-wrapper">
            <input type="tel" id="zipCode" class="input-text zip" required="">
          </div>
          <span class="invisible error-message">Please enter a valid zip code.</span>
        </div>
      </div>
    </div>
    <div class="row">
      <!-- Email Address -->
      <div class="form-field col-sm-12">
        <div id="dive">
          <label class="input-label" for="emailAddress">Email Address</label>
          <p class="input-message">A receipt will be sent to this email address.</p>
          <div class="input-wrapper">
            <input type="email" id="emailAddress" class="input-text" required="">
          </div>
          <span class="invisible error-message">Please enter a valid email address.</span>
        </div>
      </div>
    </div>
    <div class="row">
      <!-- Phone Number -->
      <div class="form-field col-sm-5">
        <div id="divph">
          <label class="input-label" for="phone">Phone Number</label>
          <p class="input-message"><a class="notice" data-toggle="collapse" href="#collapseNotice" role="button" aria-expanded="false" aria-controls="collapseNotice">Why do we ask for this?</a></p>
          <div id="collapseNotice" class="notice-expanded collapse">
            <p>This number will only be used to contact you in case of a problem.</p>
          </div>
          <div class="input-wrapper">
            <input type="tel" id="phone" class="input-number phone" required="">
          </div>
          <span class="invisible error-message">Please enter your phone number.</span>
        </div>
      </div>
    </div>
    <!-- Next Step Button -->
    <div class="row mt-4">
      <div class="col-sm-6 ml-auto">
        <button type="button" id="nextStep" class="btn-main" onclick="validateAndContinue()">Next Step<i class="fas fa-arrow-circle-right" aria-hidden="true"></i></button>
      </div>
    </div>
  </div>
  <div id="step2" hidden="">
    <!-- Step Counter -->
    <ol class="step-counter">
      <li class="step-completed">Customer Info</li>
      <li class="step-active">Payment Details</li>
    </ol>
    <hr>
    <p id="currentStep" class="small">Step 2 of 2</p>
    <!-- Customer Info Header -->
    <h2 class="form-header">Payment Details</h2>
    <!-- Form Fields -->
    <div id="noPaymentPlan">
      <div class="row">
        <!-- Fee Type -->
        <div class="form-field col-sm-7">
          <div id="divft">
            <label class="input-label" for="feeType">Fee Type</label>
            <div class="input-wrapper dropdown-wrapper">
              <select id="feeType" class="input-dropdown" placeholder="" required="">
                <option value="Band Fee">Band Fee</option>
                <option value="Other Fee">Other Fee</option>
              </select>
            </div>
            <span class="invisible error-message">Please select a fee option.</span>
          </div>
        </div>
      </div>
      <div class="row">
        <!-- Other Fee Description -->
        <div id="divfd" class="form-field col-sm-12 d-none">
          <label class="input-label" for="feeDescription">Fee Description</label>
          <div class="textarea-wrapper"><textarea id="feeDescription" class="input-textarea" placeholder="Enter description here..." name="Fee Description"></textarea>
          </div>
          <span class="invisible error-message">Please enter a fee description.</span>
        </div>
      </div>
      <div class="row">
        <!-- Payment Amount -->
        <div class="form-field col-sm-5">
          <div id="divp">
            <label class="input-label" for="paymentAmount">Payment Amount</label>
            <div class="input-wrapper">
              <input type="tel" id="paymentAmount" class="input-number currency" required="">
            </div>
            <span class="invisible error-message">Please enter a valid payment amount.</span>
          </div>
        </div>
      </div>
    </div>
    <!-- Form Navigation Buttons -->
    <div class="row justify-content-center align-items-center mt-4">
      <div class="col-sm-6 order-2 order-sm-1 mr-sm-auto">
        <button type="button" id="previousStep" class="btn-secondary" onclick="goBack()"><i class="fas fa-arrow-circle-left" aria-hidden="true"></i>Previous Step</button>
      </div>
      <div class="col-sm-6 order-1 order-sm-2 ml-sm-auto">
        <input type="text" class="d-none" name="ApiKey" value="ONLINE2tQbSOul80kHin35CewHg">
        <input hidden="" type="number" id="FeeAmountCents" name="FeeAmountCents">
        <input type="text" id="Line" name="Line[0]" class="d-none" value="">
        <input hidden="" name="TransactionIdentifier" type="text" value="TxId">
        <input type="text" id="LineHeader" class="d-none" name="LineHeader" value="Student Name, First Name, Last Name, Street Address, City, State, Zip Code, Email Address, Phone Number, Fee Type">
        <input type="text" name="ReturnUrl" class="d-none" value="http://s-cbands.org/">
        <button type="button" id="submitMe" class="btn-main" onclick="submitPayment()">Review Payment <i class="fas fa-arrow-circle-right" aria-hidden="true"></i></button>
      </div>
    </div>
  </div>
</form>

Text Content

WELCOME TO THE SMITH COTTON BANDS PAYMENT SITE.

Please enter the information required for payment processing.

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Website not compatible with Internet Explorer


 1. Customer Info
 2. Payment Details

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Step 1 of 2


CUSTOMER INFORMATION

Student's Full Name

Please enter the student's name.
Parent's First Name

Please enter your first name.
Parent's Last Name

Please enter your last name.
Street Address

Please enter the street address.
City

Please enter the city name.
State
AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MIMN MS MO MT NE
NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY
Please enter a valid state.
Zip Code

Please enter a valid zip code.
Email Address

A receipt will be sent to this email address.


Please enter a valid email address.
Phone Number

Why do we ask for this?

This number will only be used to contact you in case of a problem.


Please enter your phone number.
Next Step
 1. Customer Info
 2. Payment Details

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Step 2 of 2


PAYMENT DETAILS

Fee Type
Band Fee Other Fee
Please select a fee option.
Fee Description

Please enter a fee description.
Payment Amount

Please enter a valid payment amount.
Previous Step
Review Payment

Please allow 5 days for the payment to reflect on the student's account. A
convenience fee of $0.50 will be added to each payment transaction.

For payment questions, please contact the school's High School band teacher.

© Central Bancompany 2023. All rights reserved.