[% INCLUDE 'waste/header.html' %]

Credit Card Details

Amount
£[% amount %]
Billing Address
[% address1 %]
[% address2 %][% '
' IF address2 %] [% address3 %][% '
' IF address3 %] [% postcode %]
[% town %]
[% BLOCK form_extra %][% END %] [% INCLUDE 'waste/cc_form.html' button_text="Continue to Card Payment" %] [% INCLUDE footer.html %]