[MM_Form type='checkout'] [MM_Form_Message type='error']

[MM_Form_Section type='accountInfo']

Account Information

First Name: [MM_Form_Field type='input' name='firstName' customAttributes='placeholder="First Name"']

Last Name: [MM_Form_Field type='input' name='lastName' customAttributes='placeholder="Last Name"']

Email : [MM_Form_Field type='input' name='email' customAttributes='placeholder="Email Address"']

Password : [MM_Form_Field type='input' name='password' customAttributes='placeholder="Password"']

Phone : [MM_Form_Field type='input' name='phone' isRequired='true' customAttributes='placeholder="Phone Number"']

[/MM_Form_Section] [MM_Form_Section type='billingInfo']

Billing Details

Card Number : [MM_Form_Field name='ccNumber' customAttributes='placeholder="Credit/Debit Card"']

CVC : [MM_Form_Field name='ccSecurityCode' customAttributes='placeholder="CVC"']

Expiration Date : [MM_Form_Field name='ccExpirationDate']

[MM_Form_Field type='hidden' name='billingAddress' customAttributes='placeholder="Billing Address"']

[MM_Form_Field type='hidden' name='billingCity' customAttributes='placeholder="Billing City"']

[MM_Form_Field type='hidden' name='billingState' customAttributes='placeholder="Billing State"']

[MM_Form_Field type='hidden' name='billingZipCode' customAttributes='placeholder="Billing Zip Code"']

[MM_Form_Field type='hidden' name='billingCountry']

[/MM_Form_Section] [MM_Form_Section type='shippingInfo']

Shipping Address

Shipping Method: [MM_Form_Field name='shippingMethod']

Shipping is the same as billing [MM_Form_Field name='shippingSameAsBilling']

[MM_Form_Subsection type='shippingAddress']

Address: [MM_Form_Field name='shippingAddress' customAttributes='placeholder="Shipping Address"']

City: [MM_Form_Field name='shippingCity' customAttributes='placeholder="Shipping City"']

State: [MM_Form_Field name='shippingState' customAttributes='placeholder="Shipping State"']

Zip : [MM_Form_Field name='shippingZipCode' customAttributes='placeholder="Shipping Zip Code"']

Country: [MM_Form_Field name='shippingCountry']

[/MM_Form_Subsection]

[/MM_Form_Section]

[MM_Form_Data name='productName' useAccessName='false']

[MM_Form_Data name='productDescription']

- Product Price: [MM_Form_Data name='productPriceDescription']
- Total Price: [MM_Form_Data name='totalPrice']

[MM_Form_Section type="coupon"] [MM_Form_Field name="couponCode"] Apply Coupon [MM_Form_Message type="couponSuccess"] [MM_Form_Message type="couponError"] [/MM_Form_Section]

[MM_Form_Button type='all' label='Subscribe Now' color='red']

[/MM_Form]

See Terms & Conditions for more details.

Shipping Address

[MM_Form_Data name='productName' useAccessName='false']

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