<!DOCTYPE html PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd">
<html template="true">
<head>
<meta content="text/html; charset=ISO-8859-1"
http-equiv="content-type">
<title>Pengesahan Pembayaran</title>
</head>
<body>
<form name="borangpengesahan" method="post"
action="borang-hantar-pengesahan.php">
<div align="center">
<table style="border: 5px solid rgb(204, 204, 204);"
border="0" cellpadding="5" cellspacing="1"
width="550">
<tbody>
<tr>
<td colspan="3"
style="font-family: verdana; font-size: 20px;" bgcolor="">
<div align="center"><b>Pengesahan
Pembayaran</b></div>
</td>
</tr>
<tr>
<td colspan="3"
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<p>Sila isikan borang dibawah lengkap dengan data yang
benar dan sah sahaja. Sebarang maklumat palsu adalah dilarang sama
sekali. <font color="#ff0000">IP anda akan direkod untuk
tujuan keselamatan.</font></p>
<p><font color="#ff0000">*</font>
menandakan ruangan tersebut WAJIB di isi.</p>
</td>
</tr>
<tr>
<td colspan="3" bgcolor="">*</td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180">Nama Penuh Anda</td>
<td bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="namapembeli" size="40"
maxlength="100" type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180">Alamat Email Anda</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="emailpembeli" size="40"
maxlength="100" type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180">No.Telefon Anda</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="telefonpembeli" size="40"
maxlength="100" type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180"><span class="style1">Jumlah
Bayaran</span></td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="jumlahbayaran" size="40"
maxlength="100" type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180"><span class="style1">Kaedah
Pembayaran</span></td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<select name="kaedahpembayaran">
<option>Sila Pilih Kaedah Pembayaran</option>
<option>Bank (Online Transfer)</option>
<option>Bank (Cash Deposit)</option>
<option>Paypal</option>
<option>Money Order</option>
<option>Cheque</option>
<option>Others</option>
</select>
<font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180"><span class="style1">Tarikh
Pembayaran</span></td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="tarikhpembayaran"
value="DD/MM/YYYY" size="40" maxlength="100"
type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180"><span class="style1">Masa
Pembayaran</span></td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><input name="masapembayaran"
value="HH:MM" size="40" maxlength="100"
type="text"> <font color="#ff0000">*</font></td>
</tr>
<tr>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="" width="180">Bukti Transaksi
Pembayaran</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor="">
<center><b>:</b></center>
</td>
<td
style="font-family: verdana; font-size: 12px; text-align: left;"
bgcolor=""><textarea name="buktipembayaran"
cols="35" rows="5">
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