1 <form action="{!URL!}/modules.php?module=login&what=primera&mode=pay" method="post" style="margin-bottom: 0px">
2 <table border="0" cellspacing="0" cellpadding="0" width="440" class="member_table dashed">
4 <td colspan="3" align="center" class="member_title2 bottom2"
5 height="30"><strong>{--PRIMERA_MEMBER_PAYOUT_TITLE--}</strong></td>
8 <td width="315" class="bottom2" height="25" align="right">{--PRIMERA_MEMBER_PAYOUT_POINTS--}</td>
9 <td width="10" class="seperator bottom2"> </td>
10 <td width="115" class="bottom2"><strong>$content[points]</strong> Primera</td>
13 <td width="315" class="bottom2" height="25" align="right">{--PRIMERA_MEMBER_PAYOUT_MIN_POINTS--}</td>
14 <td width="10" class="seperator bottom2"> </td>
15 <td width="115" class="bottom2"><strong>$content[min_points]</strong> Primera</td>
18 <td colspan="3" height="3" class="seperator"> </td>
21 <td width="315" height="35" align="right">{--PRIMERA_MEMBER_NICKNAME--}</td>
22 <td width="10" class="seperator"> </td>
23 <td width="115"><input type="text" name="primera_nickname" size="10" maxlength="255" value="$content[primera_nickname]" /></td>
26 <td width="315" height="35" align="right">{--PRIMERA_MEMBER_PASSWORD--}</td>
27 <td width="10" class="seperator"> </td>
28 <td width="115"><input type="password" name="primera_password" size="10" maxlength="255" /></td>
31 <td width="315" height="35" align="right">{--PRIMERA_MEMBER_AMOUNT--}</td>
32 <td width="10" class="seperator"> </td>
33 <td width="115"><input type="text" name="amount" size="10" maxlength="255" /></td>
36 <td colspan="3" height="3" class="seperator bottom2"> </td>
39 <td colspan="3" align="center" class="member_footer">
40 <input type="reset" class="member_reset" value="{--CLEAR_FORM--}" />
41 <input type="submit" name="ok" class="member_submit" value="{--PRIMERA_MEMBER_PAYOUT_SUBMIT--}" />
46 <div class="member_note"> {--PRIMERA_MEMBER_PAYOUT_NOTE--}</strong>