<form id="frDonateForm_<?php echo $_GET['cid'];?>" name="frDonateForm" class="frForm">
	<p class="frParagraph">
		<label class="frTitle"><?php __('front_name');?></label>
		<input name="name" class="frText frW100p required"/>
	</p>
	<p class="frParagraph">
		<label class="frTitle"><?php __('front_email');?></label>
		<input name="email" class="frText frW100p required email"/>
	</p>
	<p class="frParagraph">
		<label class="frTitle"><?php __('front_phone');?></label>
		<input name="phone" class="frText frW100p"/>
	</p>
	<p class="frParagraph">
		<label class="frTitle"><?php __('front_amount_to_donate');?></label>
		<span class="frOverflow">
			<span class="frCurrencySign"><?php echo pjUtil::getCurrencySign($tpl['option_arr']['o_currency']);?></span>
			<input id="frAmount_<?php echo $_GET['cid'];?>" name="amount" value="<?php echo isset($_SESSION[$controller->defaultAmount]) ? $_SESSION[$controller->defaultAmount] : null;?>" class="frText frW50p frAmountText required"/>
		</span>
	</p>
	<p class="frParagraph">
		<label class="frTitle"><?php __('front_payment_method');?></label>
		<select name="payment_method" id="frPaymentMethod_<?php echo $_GET['cid'];?>" class="frSelect frW100p required">
			<option value="">-- <?php __('front_select_payment_method'); ?>--</option>
			<?php
			foreach (__('payment_methods', true, false) as $k => $v)
			{
				if($tpl['option_arr']['o_allow_' . $k] == 'Yes')
				{
					?><option value="<?php echo $k; ?>"><?php echo $v; ?></option><?php
				}
			}
			?>
		</select>
	</p>
	<p class="frParagraph frBoxCC" style="display: none;">
		<label class="frTitle"><?php __('front_cctype'); ?></label>
		<select name="cc_type" class="frText frW100p required">
			<option value="">---</option>
			<?php
			foreach (__('cc_types', true, false) as $k => $v)
			{
				?><option value="<?php echo $k; ?>"><?php echo $v; ?></option><?php
			}
			?>
		</select>
	</p>
	<p class="frParagraph frBoxCC" style="display: none;">
		<label class="frTitle"><?php __('front_ccnumber'); ?></label>
		<span class="inline-block">
			<input type="text" name="cc_num" class="frText frW100p required"/>
		</span>
	</p>
	<p class="frParagraph frBoxCC" style="display: none;">
		<label class="frTitle"><?php __('front_ccexp'); ?></label>
		<span class="frInlineBlock">
			<select name="cc_exp_month" class="frText frW55p required">
				<option value="">---</option>
				<?php
				$month_arr = __('months', true, false);
				ksort($month_arr);
				foreach ($month_arr as $key => $val)
				{
					?><option value="<?php echo $key;?>"><?php echo $val;?></option><?php
				}
				?>
			</select>
			<select name="cc_exp_year" class="frText frW42p required">
				<option value="">---</option>
				<?php
				$y = (int) date('Y');
				for ($i = $y; $i <= $y + 10; $i++)
				{
					?><option value="<?php echo $i; ?>"><?php echo $i; ?></option><?php
				}
				?>
			</select>
		</span>
	</p>
	<p class="frParagraph frBoxCC" style="display: none;">
		<label class="frTitle"><?php __('front_cccode'); ?></label>
		<span class="inline-block">
			<input type="text" name="cc_code" class="frText frW100p required"/>
		</span>
	</p>
	<?php
	if(!empty($tpl['arr']['terms']))
	{ 
		?>
		<p class="frParagraph">
			<span class="inline-block">
				<input type="checkbox" id="frTerms_<?php echo $_GET['cid'];?>" name="terms" class="required"/>
				<label for="frTerms_<?php echo $_GET['cid'];?>"><?php __('front_terms_conditions');?></label>
			</span>
		</p>
		<p class="frParagraph frTermsContainer">
			<span class="inline-block">
				<?php echo nl2br($tpl['arr']['terms']);?>
			</span>
		</p>
		<?php
	} 
	?>
	<p class="frParagraph">
		<label class="frTitleEmpty">&nbsp;</label>
		<span class="inline-block">
			<button type="submit" class="frButton frButtonSubmitDonate"><?php __('front_button_donate');?></button>&nbsp;<a href="#" class="frCancelDonation"><?php __('front_cancel');?></a>
		</span>
	</p>
</form>
<div id="frNoticeMessage_<?php echo $_GET['cid'];?>" class="frNoticeMessage" style="display:none;">	</div>