<center>
<font size=+2><b>Registration Verification</b></font>
</center>
<blockquote><blockquote><font size=+1 color=blue>
One More Step...</font><BR>
Please verify that the information submitted is correct.  If everything looks good, hit the <B>"Order Now!"</b> button to complete the process.
</blockquote></blockquote>
<center>
<form method=post action="{{CGI}}">
<input type=submit value="Order Now!"><BR><BR>
<table border=4 cellpadding=5 cellspacing=0>
<TR><TD colspan=2 align=center><B>Registration Type: <font color=red>{{reg_type_text}}</font></b></td></tr>

<tr>
<td colspan=2><center><b>Domains:</b></center>
<br>
{{bad_domains}}
<b>Valid Domains:</b><br>
{{domains}}
</td>
</tr>

<tr>
<td align=right><b>Registration Period:</b></td>
<td>{{period_text}}</td>
</tr>
{{VERIFY_CC_FIELDS}}
</table>

<BR>
<input type=hidden name=affiliate_id value="{{affiliate_id}}">

<input type=hidden name=reg_username value="{{reg_username}}">
<input type=hidden name=reg_password value="{{reg_password}}">
<input type=hidden name=reg_domain value="{{reg_domain}}">
<input type=hidden name=reg_type value="{{reg_type}}">
<input type=hidden name=bulk_order value="{{bulk_order}}">
<input type=hidden name=period value="{{period}}">

{{domain_string}}

{{SPECIAL_DOMAIN_INFO}}
{{CONTACT_INFO}}
{{NAMESERVER_INFO}}
{{BILLING_INFO}}

<input type=submit value="Order Now!">
<input type=hidden name=action value="{{action}}">
</form>
</center>
<BR><BR>
