@@ -0,0 +1,34 @@
+form!
+
+title "Purchase Number"
+
+instructions <<~I
+ You've selected #{@tel} as your JMP number.
+ This number has a one-time price of #{'.2f' % @tel.price}.
+ (If you'd like to pay in another cryptocurrency, currently we recommend using a service like simpleswap.io, morphtoken.com, changenow.io, or godex.io.)
+I
+
+field(
+ var: "activation_method",
+ type: "list-single",
+ label: "Activate using",
+ required: true,
+ options: [
+ {
+ value: "credit_card",
+ label: "Credit Card"
+ },
+ {
+ value: "bitcoin",
+ label: "Bitcoin"
+ },
+ {
+ value: "bch",
+ label: "Bitcoin Cash"
+ },
+ {
+ value: "code",
+ label: "Referral Code"
+ }
+ ]
+)