<div class="main-cart">
<h1>Vaše naročilo</h1>
<div class="category-bg">
<div class="category-border">
<div class="step-box">1. Dostava</div>
<div class="step-box step-box-selected">2. Plačilo</div>
<div class="step-box">3. Povzetek</div>
<div class="step-box">4. Zaključek</div>
<div class="clear"></div>
</div>
</div>
<div class="alert">Prosimo, izpolnite zahtevana polja: Ime in priimek, Naslov, Pošta, Kraj.</div>
<div class="payment-error">Payment failed!</div>
<form name="payment" class="frm-default" action="/checkout" method="POST">
<fieldset>
<legend>Plačik</legend>
<ul>
<li>
<label>Ime</label>
<input type="text" name="first_name"/>
</li>
<li>
<label>Priimek</label>
<input type="text" name="last_name"/>
</li>
<li>
<label>Naslov</label>
<input type="text" name="street_address"/>
</li>
<li>
<label>Pošta in kraj</label>
<input type="text" name="zip" class="fld-small" /> <input type="text" name="city"/>
</li>
<li>
<label>Država</label>
<input type="text" disabled value="Slovenija" />
</li>
<li>
<label>Telefon</label>
<input type="text" name="phone"/>
</li>
<li>
<label>E-mail naslov</label>
<input type="text" name="email"/>
</li>
</ul>
</fieldset>
<fieldset>
<legend>Način plačila</legend>
<ul>
<li>
<a href="" class="cart-payment">
<img src="img/amex1.gif" />
Amex
</a>
<a href="" class="cart-payment">
<img src="img/visa1.gif" />
Visa
</a>
<a href="" class="cart-payment">
<img src="img/mastercard1.gif" />
Mastercard
</a>
<a href="" class="cart-payment">
<img src="img/predracun.gif" />
Predračun
</a>
<a href="" class="cart-payment">
PayPal
</a>
</li>
<li>
<label>Številka kartice</label>
<input type="text" name="cc_number" autocomplete="off"/>
</li>
<li>
<label>Varnostna koda (CVC)</label>
<input type="text" class="fld-small" name="cvc_number" autocomplete="off"/> <a href=""><img src="img/i_info-small.png" style="margin-bottom: -5px;" /></a>
</li>
<li>
<label>Velja do (mesec/leto)</label>
<select class="fld-date" name="cc_month"><option>Mesec</option></select> <select class="fld-date" name="cc_year"><option>Leto</option></select>
</li>
</ul>
</fieldset>
<input type="submit" value="Naprej na povzetek naročila" class="btn-submit" />
</form>
</div> <!-- end main -->