
Account Information:
[MM_Form_Field type='input' name='firstName']
[MM_Form_Field type='input' name='lastName']
[MM_Form_Field type='input' name='email']
[MM_Form_Field type='input' name='password']
[MM_Form_Field type='input' name='phone' isRequired='false' value='NA']
Payment Information:
[MM_Form_Field name='ccNumber']
[MM_Form_Field name='ccSecurityCode']
[MM_Form_Field name='billingZipCode']
[MM_Form_Field name='ccExpirationDate']
[MM_Form_Field name='billingState']
[MM_Form_Field name='billingCountry']
[MM_Form_Field type="hidden" name="billingAddress"][MM_Form_Field type="hidden" name="billingCity"]Order Total: [MM_Form_Data name='totalPrice']
[MM_Form_Data name='productDescription']
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