Text Field Evaluation

Compliance Statement

Level AA compliance can be achieved using the Text form field, see Restrictions for more information.

MUST have an accessible label.
The label field in the springboard is a required field, it must be used to meet level A & AA.

pay

Text Field Label

Above Field

Left of Field

Right of Field

Below Field

pb1pcsxxzyjh

Payment Option

Cardholder Name

Credit Card #

Expiration Date

Security Code

Billing Zip Code

Make this a recurring payment?

Yes, charge me today and on the 31st of every following month. (if the month doesn't have 31 days, you will be charged on the last day of the month.)

Make this a recurring payment?

Cover the fee associated with this online transaction?

Yes, I will pay an additional {transaction_fee} to cover the cost of this transaction.

Cover the fee associated with this online transaction?

Your total payment will be .

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

Subscribe to our email newsletter?