[MM_Form_Message type=’error’]
Account Information
[MM_Form_Field type=’input’ name=’firstName’]
[MM_Form_Field type=’input’ name=’email’]
[MM_Form_Field type=’input’ name=’phone’ isRequired=’false”]
[MM_Form_Field type=’input’ name=’lastName’]
[MM_Form_Field type=’input’ name=’password’]
[/MM_Form_Section]
[MM_Form_Section type=’billingInfo’]
Billing Details
[MM_Form_Field name=’ccNumber’]
[MM_Form_Field name=’ccExpirationDate’]
[MM_Form_Field name=’ccSecurityCode’]
[MM_Form_Field name=’billingZipCode’]
Billing Address
[MM_Form_Field name=’billingAddress’]
[MM_Form_Field name=’billingState’]
[MM_Form_Field name=’billingCountry’]
[MM_Form_Field name=’billingCity’]
[/MM_Form_Section]
[MM_Form_Section type=’shippingInfo’]
Shipping Address
[MM_Form_Field name=’shippingMethod’]
Shipping is the same as billing
[MM_Form_Field name=’shippingSameAsBilling’]
[MM_Form_Subsection type=’shippingAddress’]
[MM_Form_Field name=’shippingAddress’]
[MM_Form_Field name=’shippingCity’]
[MM_Form_Field name=’shippingState’]
[MM_Form_Field name=’shippingZipCode’]
[MM_Form_Field name=’shippingCountry’]
[/MM_Form_Subsection]
[/MM_Form_Section]
[MM_Form_Data name=’productName’]
[MM_Form_Section type=’coupon’]
[MM_Form_Message type=’couponSuccess’]
[MM_Form_Message type=’couponError’]
[MM_Form_Field name=’couponCode’]
Apply Coupon
[/MM_Form_Section]
- Product Price: [MM_Form_Data name=’productPrice’]
- Total Price: [MM_Form_Data name=’totalPrice’]
[MM_Form_Data name=’productDescription’]
[MM_Order_Decision isShippable=”true”]
- Shipping Price: [MM_Form_Data name=’shippingPrice’]
[/MM_Order_Decision]
[MM_Order_Decision isDiscounted=”true”]
- Discount: [MM_Form_Data name=’discount’]
[/MM_Order_Decision]
By clicking “Submit Order” I agree to the Terms of Use and Privacy Policy
Remember: You can cancel at anytime
[/MM_Form]