| OLD | NEW |
| (Empty) | |
| 1 <form action="https://www.united.com/ual/en/us/flight-search/book-a-flight/bill
inginfo/default/rev" data-randomhash="https://www.united.com/ual/en/us/flight-se
arch/book-a-flight/billinginfo/generatehash/rev" id="billingInfoForm" method="po
st" novalidate="novalidate"><input data-val="true" data-val-required="The HasUni
tedFundOption field is required." id="HasUnitedFundOption" name="HasUnitedFundOp
tion" type="hidden" value="False"><input data-val="true" data-val-number="The fi
eld PosAddressLines must be a number." data-val-required="The PosAddressLines fi
eld is required." id="PosAddressLines" name="PosAddressLines" type="hidden" valu
e="3"><input data-val="true" data-val-required="The IsPosAddressZipBeforeCity fi
eld is required." id="IsPosAddressZipBeforeCity" name="IsPosAddressZipBeforeCity
" type="hidden" value="False"><input data-val="true" data-val-required="The IsPo
sStateVisible field is required." id="IsPosStateVisible" name="IsPosStateVisible
" type="hidden" value="True"><input data-val="true" data-val-required="The IsPos
ZipVisible field is required." id="IsPosZipVisible" name="IsPosZipVisible" type=
"hidden" value="True"><input data-val="true" data-val-required="The IsRefundable
field is required." id="IsRefundable" name="IsRefundable" type="hidden" value="
False"> <div class="panel panel-travel-info" style="disp
lay: none"> |
| 2 |
| 3 <div id="divCard0" style
="display:"> |
| 4 <div class="form
-row"> |
| 5 <div cla
ss="form-group card-type"><span aria-hidden="true" class="field-validation-valid
" data-valmsg-for="CreditCardViewModels[0].CardTypeCode" data-valmsg-replace="tr
ue"></span><div class="selector fixedWidth" id="uniform-CreditCardViewModels_0__
CardTypeCode"><span aria-hidden="true" style="-webkit-user-select: none;"></span
><label class="ifl" for="CreditCardViewModels_0__CardTypeCode" style="opacity: 1
;">Select card type<em aria-hidden="true" class="rqrd">*</em></label><select ari
a-label="Select card type" aria-required="true" autocomplete="off" data-val="tru
e" data-val-required="Please select a Card type.<!--EC:V2-->" id="CreditCardView
Models_0__CardTypeCode" name="CreditCardViewModels[0].CardTypeCode" class="prepr
oc"><option selected="selected" value=""></option> |
| 6 <option value="VI">MileagePlus Visa</option> |
| 7 <option value="VI">Visa</option> |
| 8 <option value="JC">JCB</option> |
| 9 <option value="MC">MasterCard</option> |
| 10 <option value="AX">American Express</option> |
| 11 <option value="DS">Discover Network</option> |
| 12 <option value="DC">Diners Club</option> |
| 13 <option value="TP">UATP</option> |
| 14 </select></div></div> |
| 15 </div> |
| 16 <div class="form
-row"> |
| 17 <div cla
ss="form-group card-number"><label class="ifl" for="CreditCardViewModels_0__Card
Number">Card number<em aria-hidden="true" class="rqrd">*</em></label><span aria-
hidden="true" class="field-validation-valid" data-valmsg-for="CreditCardViewMode
ls[0].CardNumber" data-valmsg-replace="true"></span><input aria-required="true"
autocomplete="off" data-privacy="no-capture" data-val="true" data-val-length="Th
e field Card number must be a string with a maximum length of 20." data-val-leng
th-max="20" data-val-regex="Please provide a valid debit or credit card number.<
!--EC:CC98-->" data-val-regex-pattern="[13456]{1}[0-9 ]{1,}" data-val-required="
Please provide a valid debit or credit card number.<!--EC:CC98-->" id="CreditCar
dViewModels_0__CardNumber" maxlength="20" name="CreditCardViewModels[0].CardNumb
er" type="text" value=""></div> |
| 18 |
| 19 <input t
ype="text" class="hidden"><input type="password" class="hidden"> |
| 20 <input i
d="CreditCardViewModels_0__EncryptedCardNumber" name="CreditCardViewModels[0].En
cryptedCardNumber" type="hidden" value=""> |
| 21 <input i
d="CreditCardViewModels_0__CardNumberLast4Digits" name="CreditCardViewModels[0].
CardNumberLast4Digits" type="hidden" value=""> |
| 22 <input i
d="CreditCardViewModels_0__CardNumberToken" name="CreditCardViewModels[0].CardNu
mberToken" type="hidden" value=""> |
| 23 <input i
d="CreditCardViewModels_0__ErrorType" name="CreditCardViewModels[0].ErrorType" t
ype="hidden" value=""> |
| 24 <input i
d="CreditCardViewModels_0__ErrorNumber" name="CreditCardViewModels[0].ErrorNumbe
r" type="hidden" value=""> |
| 25 </div> |
| 26 <div class="form
-row"> |
| 27 <div cla
ss="form-group date-month"><span aria-hidden="true" class="field-validation-vali
d" data-valmsg-for="CreditCardViewModels[0].ExpMonth" data-valmsg-replace="true"
></span><div class="selector fixedWidth" id="uniform-CreditCardViewModels_0__Exp
Month"><span aria-hidden="true" style="-webkit-user-select: none;"></span><label
class="ifl" for="CreditCardViewModels_0__ExpMonth">Expiration month<em aria-hid
den="true" class="rqrd">*</em></label><select aria-label="Expiration month" aria
-required="true" autocomplete="off" data-val="true" data-val-number="The field E
xpiration month must be a number." data-val-required="Please select an Expiratio
n month.<!--EC:V13-->" id="CreditCardViewModels_0__ExpMonth" name="CreditCardVie
wModels[0].ExpMonth" class="preproc"><option selected="selected" value=""></opti
on> |
| 28 <option value="1">01 - January</option> |
| 29 <option value="2">02 - February</option> |
| 30 <option value="3">03 - March</option> |
| 31 <option value="4">04 - April</option> |
| 32 <option value="5">05 - May</option> |
| 33 <option value="6">06 - June</option> |
| 34 <option value="7">07 - July</option> |
| 35 <option value="8">08 - August</option> |
| 36 <option value="9">09 - September</option> |
| 37 <option value="10">10 - October</option> |
| 38 <option value="11">11 - November</option> |
| 39 <option value="12">12 - December</option> |
| 40 </select></div></div> |
| 41 <div cla
ss="form-group card-exp-year"><span aria-hidden="true" class="field-validation-v
alid" data-valmsg-for="CreditCardViewModels[0].ExpYear" data-valmsg-replace="tru
e"></span><div class="selector fixedWidth" id="uniform-CreditCardViewModels_0__E
xpYear"><span aria-hidden="true" style="-webkit-user-select: none;"></span><labe
l class="ifl" for="CreditCardViewModels_0__ExpYear">Year<em aria-hidden="true" c
lass="rqrd">*</em></label><select aria-label="Year" aria-required="true" autocom
plete="off" data-val="true" data-val-number="The field Expiration year must be a
number." data-val-required="Please select an Expiration year.<!--EC:V13-->" id=
"CreditCardViewModels_0__ExpYear" name="CreditCardViewModels[0].ExpYear" class="
preproc"><option selected="selected" value=""></option> |
| 42 <option value="2016">2016</option> |
| 43 <option value="2017">2017</option> |
| 44 <option value="2018">2018</option> |
| 45 <option value="2019">2019</option> |
| 46 <option value="2020">2020</option> |
| 47 <option value="2021">2021</option> |
| 48 <option value="2022">2022</option> |
| 49 <option value="2023">2023</option> |
| 50 <option value="2024">2024</option> |
| 51 <option value="2025">2025</option> |
| 52 <option value="2026">2026</option> |
| 53 </select></div></div> |
| 54 <div id=
"divCreditCardSecurityCode0" class="form-groupset"> |
| 55
<div class="form-group card-security-code"><label class="ifl" for="CreditCardVie
wModels_0__SecurityCode">Security code<em aria-hidden="true" class="rqrd">*</em>
</label><span aria-hidden="true" class="field-validation-valid" data-valmsg-for=
"CreditCardViewModels[0].SecurityCode" data-valmsg-replace="true"></span><input
aria-required="true" autocomplete="off" data-privacy="no-capture" data-val="true
" data-val-length="The field Security code must be a string with a maximum lengt
h of 4." data-val-length-max="4" data-val-regex="Please enter a valid Security c
ode.<!--EC:V15-->" data-val-regex-pattern="[abcdefghijklmnopqrstuvwxyzABCDEFGHIJ
KLMNOPQRSTUVWXYZ0123456789 ,///-]{3,}" data-val-required="Please enter a Securit
y code.<!--EC:V1-->" id="CreditCardViewModels_0__SecurityCode" maxlength="4" nam
e="CreditCardViewModels[0].SecurityCode" type="password" value=""></div> |
| 56
<button type="button" class="icon-tooltip-large-clear-bg tool-tip-security-code"
data-toggle="tooltip" data-tooltip-style="default" tabindex="0" data-hasqtip="3
" oldtitle="What's a security code?" title=""><span class="visuallyhidden">About
credit card security code</span></button> |
| 57
<div class="tip-security-code"> |
| 58
<div class="tip-security-code-default"> |
| 59
<h6>Security code</h6> |
| 60
<p>The card security code consists of the last three digits of t
he number on the back of your Visa, MasterCard or Discover Card, or the four dig
its above the main number on your American Express card.</p> |
| 61
</div> |
| 62
<div class="tip-security-code-visa" style="display: none;"> |
| 63
<h6>Visa - CVV2</h6> |
| 64
<p>The card security code consists of the last three digits of t
he number on the back of your Visa.</p> |
| 65
<img src="https://www.united.com/web/format/img/card/CVV2_Visa.G
IF" alt="Visa security code"> |
| 66
</div> |
| 67
<div class="tip-security-code-mc" style="display: none;"> |
| 68
<h6>MasterCard - CVC2</h6> |
| 69
<p>The card security code consists of the last three digits of t
he number on the back of your MasterCard.</p> |
| 70
<img src="https://www.united.com/web/format/img/card/CVC2_MC.GIF
" alt="MasterCard security code"> |
| 71
</div> |
| 72
<div class="tip-security-code-amex" style="display: none;"> |
| 73
<h6>American Express – CID</h6> |
| 74
<p>The card security code consists of the four digits above the
main number on your American Express card.</p> |
| 75
<img src="https://www.united.com/web/format/img/card/CID_Amex.GI
F" alt="American Express security code"> |
| 76
</div> |
| 77
<div class="tip-security-code-discover" style="display: none;"> |
| 78
<h6>Discover – CID</h6> |
| 79
<p>The card security code consists of the last three digits of t
he number on the back of your Discover Card.</p> |
| 80
<img src="https://www.united.com/web/format/img/card/CID_Discove
r.GIF" alt="Discover security code"> |
| 81
</div> |
| 82
</div> |
| 83 </div> |
| 84 </div> |
| 85 <div class="form
-row"> |
| 86 <div cla
ss="form-group card-holder-name"><label class="ifl" for="CreditCardViewModels_0_
_CardHolderName">Full name as it appears on your card<em aria-hidden="true" clas
s="rqrd">*</em></label><span aria-hidden="true" class="field-validation-valid" d
ata-valmsg-for="CreditCardViewModels[0].CardHolderName" data-valmsg-replace="tru
e"></span><input aria-required="true" data-val="true" data-val-length="The field
Full name as it appears on your card must be a string with a maximum length of
35." data-val-length-max="35" data-val-regex="Please enter a valid Full name as
it appears on your card.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z]{1,}[A-Za
-z '-.]{1,}" data-val-required="Please enter a Full name as it appears on your c
ard.<!--EC:V1-->" id="CreditCardViewModels_0__CardHolderName" maxlength="35" nam
e="CreditCardViewModels[0].CardHolderName" type="text" value=""></div> |
| 87 </div> |
| 88 <div class="form
-row"> |
| 89 <div cla
ss="form-group address-line"><label class="ifl" for="CreditCardViewModels_0__Add
ressLine1">Billing address line 1<em aria-hidden="true" class="rqrd">*</em></lab
el><span aria-hidden="true" class="field-validation-valid" data-valmsg-for="Cred
itCardViewModels[0].AddressLine1" data-valmsg-replace="true"></span><input aria-
required="true" data-val="true" data-val-length="The field Billing address line
1 must be a string with a maximum length of 30." data-val-length-max="30" data-v
al-regex="Please enter a valid Billing address line 1.<!--EC:V15-->" data-val-re
gex-pattern="[A-Za-z0-9]{1}[A-Za-z0-9 '\-,\./#]{1,}" data-val-required="Please e
nter a Billing address line 1.<!--EC:V1-->" id="CreditCardViewModels_0__AddressL
ine1" maxlength="30" name="CreditCardViewModels[0].AddressLine1" type="text" val
ue=""></div> |
| 90 </div> |
| 91 <div class="form
-row"> |
| 92 <div cla
ss="form-group address-line"><label class="ifl" for="CreditCardViewModels_0__Add
ressLine2">Billing address line 2 (Optional)</label><span aria-hidden="true" cla
ss="field-validation-valid" data-valmsg-for="CreditCardViewModels[0].AddressLine
2" data-valmsg-replace="true"></span><input data-val="true" data-val-length="The
field Billing address line 2 (Optional) must be a string with a maximum length
of 30." data-val-length-max="30" data-val-regex="Please enter a valid Billing ad
dress line 2 (Optional).<!--EC:V15-->" data-val-regex-pattern="[A-Za-z0-9]{1}[A-
Za-z0-9 '\-,\./#]{1,}" id="CreditCardViewModels_0__AddressLine2" maxlength="30"
name="CreditCardViewModels[0].AddressLine2" type="text" value=""></div> |
| 93 </div> |
| 94 <div class="form
-row"> |
| 95 <div cla
ss="form-group address-line"><label class="ifl" for="CreditCardViewModels_0__Add
ressLine3">Billing address line 3 (Optional)</label><span aria-hidden="true" cla
ss="field-validation-valid" data-valmsg-for="CreditCardViewModels[0].AddressLine
3" data-valmsg-replace="true"></span><input data-val="true" data-val-length="The
field Billing address line 3 (Optional) must be a string with a maximum length
of 30." data-val-length-max="30" data-val-regex="Please enter a valid Billing ad
dress line 3 (Optional).<!--EC:V15-->" data-val-regex-pattern="[A-Za-z0-9]{1}[A-
Za-z0-9 '\-,\./#]{1,}" id="CreditCardViewModels_0__AddressLine3" maxlength="30"
name="CreditCardViewModels[0].AddressLine3" type="text" value=""></div> |
| 96 </div> |
| 97
<div class="form-row"> |
| 98 <div cla
ss="form-group address-city"><label class="ifl" for="CreditCardViewModels_0__Cit
y">City/town/department<em aria-hidden="true" class="rqrd">*</em></label><span a
ria-hidden="true" class="field-validation-valid" data-valmsg-for="CreditCardView
Models[0].City" data-valmsg-replace="true"></span><input aria-required="true" da
ta-val="true" data-val-length="The field City/town/department must be a string w
ith a maximum length of 30." data-val-length-max="30" data-val-regex="Please ent
er a valid City/town/department.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z.,
\-]{2,}" data-val-required="Please enter a City/town/department.<!--EC:V1-->" i
d="CreditCardViewModels_0__City" maxlength="30" name="CreditCardViewModels[0].Ci
ty" type="text" value=""></div> |
| 99 <div class="form-group address-state"><label class="ifl" for="CreditCardViewMode
ls_0__StateCode">State/province/region/county<em aria-hidden="true" class="rqrd"
>*</em></label><span aria-hidden="true" class="field-validation-valid" data-valm
sg-for="CreditCardViewModels[0].StateCode" data-valmsg-replace="true"></span><in
put aria-required="true" data-val="true" data-val-regex="Please enter a valid St
ate/province/region/county.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z., ]{2,
}" data-val-required="Please enter a State/province/region/county.<!--EC:V1-->"
id="CreditCardViewModels_0__StateCode" name="CreditCardViewModels[0].StateCode"
type="text" value=""></div>
<div class="form-group address-post-code"><label class="ifl" for="Credit
CardViewModels_0__PostalCode">ZIP/Postal code<em aria-hidden="true" class="rqrd"
>*</em></label><span aria-hidden="true" class="field-validation-valid" data-valm
sg-for="CreditCardViewModels[0].PostalCode" data-valmsg-replace="true"></span><i
nput aria-required="true" data-val="true" data-val-length="The field ZIP/Postal
code must be a string with a maximum length of 10." data-val-length-max="10" dat
a-val-regex="Please enter a valid ZIP/Postal code.<!--EC:V15-->" data-val-regex-
pattern="[abcdefghijklmnopqrstuvwxyzABCDEFGHIJKLMNOPQRSTUVWXYZ0123456789 ,///-]{
1,}" data-val-required="Please enter a ZIP/Postal code.<!--EC:V1-->" id="CreditC
ardViewModels_0__PostalCode" maxlength="10" name="CreditCardViewModels[0].Postal
Code" type="text" value=""></div>
</div> |
| 100 <div class="form
-row"> |
| 101 <div cla
ss="form-group address-country"> |
| 102
<div class="form-group"><span aria-hidden="true" class="field-validation-valid"
data-valmsg-for="CreditCardViewModels[0].CountryCode" data-valmsg-replace="true"
></span><div class="selector fixedWidth" id="uniform-CreditCardViewModels_0__Cou
ntryCode"><span aria-hidden="true" style="-webkit-user-select: none;">United Sta
tes</span><label class="ifl visuallyhidden" for="CreditCardViewModels_0__Country
Code">Country<em aria-hidden="true" class="rqrd">*</em></label><select aria-labe
l="Country" aria-required="true" data-val="true" data-val-required="The Country
field is required." id="CreditCardViewModels_0__CountryCode" name="CreditCardVie
wModels[0].CountryCode" class="preproc"><option selected="selected" value="US">U
nited States</option> |
| 103 <option value="CA">Canada</option> |
| 104 <option value="GB">United Kingdom</option> |
| 105 <option value="AG">Antigua and Barbuda</option> |
| 106 <option value="AR">Argentina</option> |
| 107 <option value="AW">Aruba</option> |
| 108 <option value="AU">Australia</option> |
| 109 <option value="BS">Bahamas</option> |
| 110 <option value="BH">Bahrain</option> |
| 111 <option value="BB">Barbados</option> |
| 112 <option value="BE">Belgium</option> |
| 113 <option value="BZ">Belize</option> |
| 114 <option value="BM">Bermuda</option> |
| 115 <option value="BR">Brazil</option> |
| 116 <option value="CA">Canada</option> |
| 117 <option value="KY">Cayman Islands</option> |
| 118 <option value="CL">Chile</option> |
| 119 <option value="CN">China</option> |
| 120 <option value="CO">Colombia</option> |
| 121 <option value="CR">Costa Rica</option> |
| 122 <option value="DK">Denmark</option> |
| 123 <option value="DO">Dominican Republic</option> |
| 124 <option value="EC">Ecuador</option> |
| 125 <option value="SV">El Salvador</option> |
| 126 <option value="FR">France</option> |
| 127 <option value="DE">Germany</option> |
| 128 <option value="GR">Greece</option> |
| 129 <option value="GU">Guam</option> |
| 130 <option value="GT">Guatemala</option> |
| 131 <option value="HN">Honduras</option> |
| 132 <option value="HK">Hong Kong</option> |
| 133 <option value="IN">India</option> |
| 134 <option value="ID">Indonesia</option> |
| 135 <option value="IE">Ireland</option> |
| 136 <option value="IL">Israel</option> |
| 137 <option value="IT">Italy</option> |
| 138 <option value="JM">Jamaica</option> |
| 139 <option value="JP">Japan</option> |
| 140 <option value="KR">Korea, South</option> |
| 141 <option value="KW">Kuwait</option> |
| 142 <option value="MH">Marshall Islands</option> |
| 143 <option value="MX">Mexico</option> |
| 144 <option value="FM">Micronesia</option> |
| 145 <option value="NL">Netherlands</option> |
| 146 <option value="AN">Netherlands Antilles</option> |
| 147 <option value="NZ">New Zealand</option> |
| 148 <option value="NI">Nicaragua</option> |
| 149 <option value="MP">Northern Mariana Islands</option> |
| 150 <option value="NO">Norway</option> |
| 151 <option value="PW">Palau</option> |
| 152 <option value="PA">Panama</option> |
| 153 <option value="PE">Peru</option> |
| 154 <option value="PH">Philippines</option> |
| 155 <option value="PT">Portugal</option> |
| 156 <option value="PR">Puerto Rico</option> |
| 157 <option value="QA">Qatar</option> |
| 158 <option value="RU">Russia</option> |
| 159 <option value="SG">Singapore</option> |
| 160 <option value="ES">Spain & Canary Islands</option> |
| 161 <option value="SE">Sweden</option> |
| 162 <option value="CH">Switzerland</option> |
| 163 <option value="TW">Taiwan</option> |
| 164 <option value="TH">Thailand</option> |
| 165 <option value="TT">Trinidad and Tobago</option> |
| 166 <option value="TR">Turkey</option> |
| 167 <option value="AE">United Arab Emirates</option> |
| 168 <option value="GB">United Kingdom</option> |
| 169 <option selected="selected" value="US">United States</option> |
| 170 <option value="VN">Vietnam</option> |
| 171 </select></div></div> |
| 172 </div> |
| 173 </div> |
| 174 |
| 175 <p>Your bank may
apply a credit card conversion fee.</p> |
| 176 |
| 177 </div> |
| 178 </fieldset> |
| 179 </div> |
| 180 <div class="panel-body-section"
id="divOtherFop" style="display"> |
| 181 <div id="fop-other-alert
"> |
| 182 <div class="payment-noti
ce"><i class="icon-information-small-gray"></i> Alipay is not eligible forms of
payment based on your current selections.</div> |
| 183 </div> |
| 184 <div id="fop-other" clas
s="label-payment-type" style=""> |
| 185 <div class="form
-group"> |
| 186 <span ar
ia-hidden="true" class="field-validation-valid" data-valmsg-for="FOPOption" data
-valmsg-replace="true"></span><div class="radio" id="uniform-FOPOption_OtherFop"
><span><input aria-required="true" class="type-radio rotherform preproc" id="FOP
Option_OtherFop" name="FOPOption" tabindex="0" type="radio" value="OtherFop"></s
pan></div><label class="radio" for="FOPOption_OtherFop">Other forms of payment</
label> |
| 187 </div> |
| 188 <div id="fop-oth
er-images" class="form-group container-payment-type-images fop-other"> |
| 189 <ul><li>
<i class="icon-payment-type-visa-checkout-small" title="Visa Checkout"><span cla
ss="visuallyhidden">Visa Checkout</span></i></li><li><i class="icon-payment-type
-check-small" title="TeleCheck Online Checks"><span class="visuallyhidden">TeleC
heck Online Checks</span></i></li><li><i class="icon-payment-type-cash-small" ti
tle="Western Union Cash"><span class="visuallyhidden">Western Union Cash</span><
/i></li><li><i class="icon-payment-type-paypal-small" title="PayPal"><span class
="visuallyhidden">PayPal</span></i></li><li><i class="icon-payment-type-bill-me-
later-small" title="PayPal Credit"><span class="visuallyhidden">PayPal Credit</s
pan></i></li></ul> |
| 190 </div> |
| 191 </div> |
| 192 |
| 193 |
| 194 <div id="other-fop-secti
on" style=""> |
| 195 <div class="form
-row section-other-fop" id="other_fop_list" style="display: none;"> |
| 196 <label f
or="OtherFOPType" class="visuallyhidden">Form of payment</label> |
| 197 <div cla
ss="selector fixedWidth" id="uniform-OtherFOPType"><span aria-hidden="true" styl
e="-webkit-user-select: none;">Not Selected</span><select class="ddlotherfop pre
proc" data-cartid="83029498-98C8-4043-AA9B-106E1F89C4BF" data-fopurl="https://ww
w.united.com/ual/en/us/flight-search/book-a-flight/billinginfo/getotherfops/rev"
id="OtherFOPType" name="OtherFOPType"><option hideoptions="" value="">Not Selec
ted</option><option hideoptions="" value="VCO">Visa Checkout</option><option hid
eoptions="PAS, AAC" value="CASH">Cash</option><option hideoptions="PAS, AAC" val
ue="CHECK">Online check</option><option hideoptions="" value="PP">PayPal</option
><option hideoptions="" value="BML">PayPal Credit</option></select></div> |
| 198 |
| 199 |
| 200 <a href=
"https://www.united.com/web/en-US/content/booking/flight/whatIsBML.aspx" target=
"_blank" class="info-link" id="BML-info-link">What is PayPal Credit?</a> |
| 201 <a href=
"https://www.united.com/web/en-US/content/booking/flight/whatispaypal.aspx" targ
et="_blank" class="info-link" id="PayPal-info-link">What is PayPal?</a> |
| 202 </div> |
| 203 <div class="sect
ion-PayPal-type" style="display: none;"> |
| 204 <p>You w
ill be directed to PayPal's website to enroll or to sign in to your account. You
will then be redirected to united.com to complete this purchase.</p> |
| 205 <input t
ype="hidden" id="paypalUrl"> |
| 206 <button
class="btn" id="btnPayPalCheckOut" value="PayPal">Check out with PayPal</button> |
| 207 </div> |
| 208 <div class="sect
ion-Alipay-type" style="display: none;"> |
| 209 <input t
ype="hidden" id="alipayUrl"> |
| 210 <fieldse
t> |
| 211
<legend class="visuallyhidden">Billing information <small class="required" aria-
required="true">(*Required)</small></legend> |
| 212
<h4 class="legend">Billing information <small class="required" aria-required="tr
ue">(*Required)</small></h4> |
| 213
<p>Please enter the purchaser's name and billing address below. Selecting "Purch
ase" will direct you to Alipay's website to enroll or to sign in to your account
. You'll then be redirected to united.com for your purchase confirmation.</p> |
| 214
<div class="form-row"> |
| 215
<div class="form-group card-holder-name"><label class="ifl" for="AlipayC
ardHolderName">Full name as it appears on your card<em aria-hidden="true" class=
"rqrd">*</em></label><span aria-hidden="true" class="field-validation-valid" dat
a-valmsg-for="AlipayCardHolderName" data-valmsg-replace="true"></span><input ari
a-required="true" data-val="true" data-val-length="The field Full name as it app
ears on your card must be a string with a maximum length of 35." data-val-length
-max="35" data-val-regex="Please enter a valid Full name as it appears on your c
ard.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z]{1,}[A-Za-z '-.]{1,}" data-va
l-required="Please enter a Full name as it appears on your card.<!--EC:V1-->" id
="AlipayCardHolderName" maxlength="35" name="AlipayCardHolderName" type="text" v
alue=""></div> |
| 216
</div> |
| 217
<div class="form-row"> |
| 218
<div class="form-group address-line"><label class="ifl" for="AlipayBilli
ngAddressLine1">Billing address line 1<em aria-hidden="true" class="rqrd">*</em>
</label><span aria-hidden="true" class="field-validation-valid" data-valmsg-for=
"AlipayBillingAddressLine1" data-valmsg-replace="true"></span><input aria-requir
ed="true" data-val="true" data-val-length="The field Billing address line 1 must
be a string with a maximum length of 30." data-val-length-max="30" data-val-reg
ex="Please enter a valid Billing address line 1.<!--EC:V15-->" data-val-regex-pa
ttern="[A-Za-z0-9]{1}[A-Za-z0-9 '\-,\./#]{1,}" data-val-required="Please enter a
Billing address line 1.<!--EC:V1-->" id="AlipayBillingAddressLine1" maxlength="
30" name="AlipayBillingAddressLine1" type="text" value=""></div> |
| 219
</div> |
| 220
<div class="form-row"> |
| 221
<div class="form-group address-line"><label class="ifl" for="AlipayBilli
ngAddressLine2">Billing address line 2 (Optional)</label><span aria-hidden="true
" class="field-validation-valid" data-valmsg-for="AlipayBillingAddressLine2" dat
a-valmsg-replace="true"></span><input data-val="true" data-val-length="The field
Billing address line 2 (Optional) must be a string with a maximum length of 30.
" data-val-length-max="30" data-val-regex="Please enter a valid Billing address
line 2 (Optional).<!--EC:V15-->" data-val-regex-pattern="[A-Za-z0-9]{1}[A-Za-z0-
9 '\-,\./#]{1,}" id="AlipayBillingAddressLine2" maxlength="30" name="AlipayBilli
ngAddressLine2" type="text" value=""></div> |
| 222
</div> |
| 223
<div class="form-row"> |
| 224
<div class="form-group address-line"><label class="ifl" for="AlipayBilli
ngAddressLine3">Billing address line 3 (Optional)</label><span aria-hidden="true
" class="field-validation-valid" data-valmsg-for="AlipayBillingAddressLine3" dat
a-valmsg-replace="true"></span><input data-val="true" data-val-length="The field
Billing address line 3 (Optional) must be a string with a maximum length of 30.
" data-val-length-max="30" data-val-regex="Please enter a valid Billing address
line 3 (Optional).<!--EC:V15-->" data-val-regex-pattern="[A-Za-z0-9]{1}[A-Za-z0-
9 '\-,\./#]{1,}" id="AlipayBillingAddressLine3" maxlength="30" name="AlipayBilli
ngAddressLine3" type="text" value=""></div> |
| 225
</div> |
| 226
<div class="form-row"> |
| 227
<div class="form-group address-city"><label class="ifl" for="AlipayCity"
>City/town/department<em aria-hidden="true" class="rqrd">*</em></label><span ari
a-hidden="true" class="field-validation-valid" data-valmsg-for="AlipayCity" data
-valmsg-replace="true"></span><input aria-required="true" data-val="true" data-v
al-length="The field City/town/department must be a string with a maximum length
of 30." data-val-length-max="30" data-val-regex="Please enter a valid City/town
/department.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z., \-]{2,}" data-val-r
equired="Please enter a City/town/department.<!--EC:V1-->" id="AlipayCity" maxle
ngth="30" name="AlipayCity" type="text" value=""></div> |
| 228
<div class="form-group paypal-address-post-code"><label class="ifl" for=
"AlipayZipCode">ZIP/Postal code<em aria-hidden="true" class="rqrd">*</em></label
><span aria-hidden="true" class="field-validation-valid" data-valmsg-for="Alipay
ZipCode" data-valmsg-replace="true"></span><input aria-required="true" data-val=
"true" data-val-length="The field ZIP/Postal code must be a string with a maximu
m length of 10." data-val-length-max="10" data-val-regex="Please enter a valid Z
IP/Postal code.<!--EC:V15-->" data-val-regex-pattern="[abcdefghijklmnopqrstuvwxy
zABCDEFGHIJKLMNOPQRSTUVWXYZ0123456789 ,///-]{1,}" data-val-required="Please ente
r a ZIP/Postal code.<!--EC:V1-->" id="AlipayZipCode" maxlength="10" name="Alipay
ZipCode" type="text" value=""></div> |
| 229
</div> |
| 230
<div class="form-row"> |
| 231
<div class="selector fixedWidth" id="uniform-AlipayCountryCode"><span ar
ia-hidden="true" style="-webkit-user-select: none;">United States</span><select
class="phone-country-list preproc" id="AlipayCountryCode" name="AlipayCountryCod
e"><option selected="selected" value="US">United States</option> |
| 232 <option value="CA">Canada</option> |
| 233 <option value="GB">United Kingdom</option> |
| 234 <option value="AG">Antigua and Barbuda</option> |
| 235 <option value="AR">Argentina</option> |
| 236 <option value="AW">Aruba</option> |
| 237 <option value="AU">Australia</option> |
| 238 <option value="BS">Bahamas</option> |
| 239 <option value="BH">Bahrain</option> |
| 240 <option value="BB">Barbados</option> |
| 241 <option value="BE">Belgium</option> |
| 242 <option value="BZ">Belize</option> |
| 243 <option value="BM">Bermuda</option> |
| 244 <option value="BR">Brazil</option> |
| 245 <option value="CA">Canada</option> |
| 246 <option value="KY">Cayman Islands</option> |
| 247 <option value="CL">Chile</option> |
| 248 <option value="CN">China</option> |
| 249 <option value="CO">Colombia</option> |
| 250 <option value="CR">Costa Rica</option> |
| 251 <option value="DK">Denmark</option> |
| 252 <option value="DO">Dominican Republic</option> |
| 253 <option value="EC">Ecuador</option> |
| 254 <option value="SV">El Salvador</option> |
| 255 <option value="FR">France</option> |
| 256 <option value="DE">Germany</option> |
| 257 <option value="GR">Greece</option> |
| 258 <option value="GU">Guam</option> |
| 259 <option value="GT">Guatemala</option> |
| 260 <option value="HN">Honduras</option> |
| 261 <option value="HK">Hong Kong</option> |
| 262 <option value="IN">India</option> |
| 263 <option value="ID">Indonesia</option> |
| 264 <option value="IE">Ireland</option> |
| 265 <option value="IL">Israel</option> |
| 266 <option value="IT">Italy</option> |
| 267 <option value="JM">Jamaica</option> |
| 268 <option value="JP">Japan</option> |
| 269 <option value="KR">Korea, South</option> |
| 270 <option value="KW">Kuwait</option> |
| 271 <option value="MH">Marshall Islands</option> |
| 272 <option value="MX">Mexico</option> |
| 273 <option value="FM">Micronesia</option> |
| 274 <option value="NL">Netherlands</option> |
| 275 <option value="AN">Netherlands Antilles</option> |
| 276 <option value="NZ">New Zealand</option> |
| 277 <option value="NI">Nicaragua</option> |
| 278 <option value="MP">Northern Mariana Islands</option> |
| 279 <option value="NO">Norway</option> |
| 280 <option value="PW">Palau</option> |
| 281 <option value="PA">Panama</option> |
| 282 <option value="PE">Peru</option> |
| 283 <option value="PH">Philippines</option> |
| 284 <option value="PT">Portugal</option> |
| 285 <option value="PR">Puerto Rico</option> |
| 286 <option value="QA">Qatar</option> |
| 287 <option value="RU">Russia</option> |
| 288 <option value="SG">Singapore</option> |
| 289 <option value="ES">Spain & Canary Islands</option> |
| 290 <option value="SE">Sweden</option> |
| 291 <option value="CH">Switzerland</option> |
| 292 <option value="TW">Taiwan</option> |
| 293 <option value="TH">Thailand</option> |
| 294 <option value="TT">Trinidad and Tobago</option> |
| 295 <option value="TR">Turkey</option> |
| 296 <option value="AE">United Arab Emirates</option> |
| 297 <option value="GB">United Kingdom</option> |
| 298 <option selected="selected" value="US">United States</option> |
| 299 <option value="VN">Vietnam</option> |
| 300 </select></div> |
| 301
</div> |
| 302 </fields
et> |
| 303 </div> |
| 304 <div class="sect
ion-VisaCheckout-type" style="display: none;"> |
| 305 <input i
d="WalletVCOEnvironment" name="WalletVCOEnvironment" type="hidden" value="prod"> |
| 306 <input d
ata-val="true" data-val-required="Please enter a WalletId.<!--EC:V1-->" id="Wall
etId" name="WalletId" type="hidden" value=""> |
| 307 <input i
d="WalletCardType" name="WalletCardType" type="hidden" value=""> |
| 308 <input i
d="WalletCreditCardTypeList" name="WalletCreditCardTypeList" type="hidden" value
="["VISA","JCB","MASTERCARD","AMEX",&quo
t;DISCOVER","DINERS","UATP"]"> |
| 309 <input i
d="WalletBillingAddress" name="WalletBillingAddress" type="hidden" value=""> |
| 310 <input i
d="WalletBillingCity" name="WalletBillingCity" type="hidden" value=""> |
| 311 <input i
d="WalletBillingZipCode" name="WalletBillingZipCode" type="hidden" value=""> |
| 312 <input i
d="WalletBillingCountryCode" name="WalletBillingCountryCode" type="hidden" value
=""> |
| 313 <input t
ype="hidden" name="vcoTotalCartAmount" id="vcoTotalCartAmount"> |
| 314 <input t
ype="hidden" name="vcoCurrencyCode" id="vcoCurrencyCode"> |
| 315 <p>To us
e Visa Checkout, click the button below. You will be prompted to log in or creat
e an account.</p> |
| 316 <button
class="btn-visa" id="btnVisaCheckOut" value="Visa Checkout"> |
| 317
<img class="btn-img-visa" alt="Use Visa Checkout" src="https://sandbox.secure.ch
eckout.visa.com/wallet-services-web/xo/button.png"> |
| 318 </button
> |
| 319 </div> |
| 320 <div id="spinner
-visaCheckout" class="spinner-container-visa-checkout-form" style="display: none
"> </div> |
| 321 <div id="form-pa
yPal" class="form-PayPal" style="display: none"> |
| 322 <div cla
ss="PayPal-selected-info"> |
| 323
<i class="icon-payment-type-paypal"></i> |
| 324
<p><span id="paypalName"></span>, you have selected PayPal as your payment metho
d. PayPal account: <span id="paypalEmail"></span></p> |
| 325 </div> |
| 326 |
| 327 <fieldse
t> |
| 328
<legend class="visuallyhidden">Billing information <small class="rqrd" aria-hidd
en="true">(*Required)</small></legend> |
| 329
<h4 class="legend">Billing information <small class="rqrd" aria-hidden="true">(*
Required)</small></h4> |
| 330
<p>Please enter the billing information associated with the specified PayPal acc
ount.</p> |
| 331
<div class="form-row"> |
| 332
<div class="form-group paypal-address-line"><label class="ifl" for="PayP
alBillingAddress">Billing address<em aria-hidden="true" class="rqrd">*</em></lab
el><span aria-hidden="true" class="field-validation-valid" data-valmsg-for="PayP
alBillingAddress" data-valmsg-replace="true"></span><input aria-required="true"
data-val="true" data-val-length="The field Billing address must be a string with
a maximum length of 30." data-val-length-max="30" data-val-regex="Please enter
a valid Billing address.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z0-9]{1}[A-
Za-z0-9 '\-,\./#]{1,}" data-val-required="Please enter a Billing address.<!--EC:
V1-->" id="PayPalBillingAddress" maxlength="30" name="PayPalBillingAddress" type
="text" value=""></div> |
| 333
</div> |
| 334
<div class="form-row"> |
| 335
<div class="form-group address-city"><label class="ifl" for="PayPalCity"
>City/town/department<em aria-hidden="true" class="rqrd">*</em></label><span ari
a-hidden="true" class="field-validation-valid" data-valmsg-for="PayPalCity" data
-valmsg-replace="true"></span><input aria-required="true" data-val="true" data-v
al-length="The field City/town/department must be a string with a maximum length
of 30." data-val-length-max="30" data-val-regex="Please enter a valid City/town
/department.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z., \-]{2,}" data-val-r
equired="Please enter a City/town/department.<!--EC:V1-->" id="PayPalCity" maxle
ngth="30" name="PayPalCity" type="text" value=""></div> |
| 336
<div class="form-group address-state"><label class="ifl" for="PayPalStat
e">State/province/region/county<em aria-hidden="true" class="rqrd">*</em></label
><span aria-hidden="true" class="field-validation-valid" data-valmsg-for="PayPal
State" data-valmsg-replace="true"></span><input aria-required="true" data-val="t
rue" data-val-required="Please enter a State/province/region/county.<!--EC:V1-->
" id="PayPalState" name="PayPalState" type="text" value=""></div> |
| 337
<div class="form-group paypal-address-post-code"><label class="ifl" for=
"PayPalZipCode">ZIP/Postal code<em aria-hidden="true" class="rqrd">*</em></label
><span aria-hidden="true" class="field-validation-valid" data-valmsg-for="PayPal
ZipCode" data-valmsg-replace="true"></span><input aria-required="true" data-val=
"true" data-val-length="The field ZIP/Postal code must be a string with a maximu
m length of 10." data-val-length-max="10" data-val-regex="Please enter a valid Z
IP/Postal code.<!--EC:V15-->" data-val-regex-pattern="[abcdefghijklmnopqrstuvwxy
zABCDEFGHIJKLMNOPQRSTUVWXYZ0123456789 ,///-]{1,}" data-val-required="Please ente
r a ZIP/Postal code.<!--EC:V1-->" id="PayPalZipCode" maxlength="10" name="PayPal
ZipCode" type="text" value=""></div> |
| 338
</div> |
| 339
<div class="form-row"> |
| 340
<div class="selector fixedWidth" id="uniform-PayPalCountryCode"><span ar
ia-hidden="true" style="-webkit-user-select: none;">United States</span><select
class="address-country preproc" id="PayPalCountryCode" name="PayPalCountryCode">
<option value="US">United States</option> |
| 341 <option value="CA">Canada</option> |
| 342 <option value="GB">United Kingdom</option> |
| 343 <option value="AG">Antigua and Barbuda</option> |
| 344 <option value="AR">Argentina</option> |
| 345 <option value="AW">Aruba</option> |
| 346 <option value="AU">Australia</option> |
| 347 <option value="BS">Bahamas</option> |
| 348 <option value="BH">Bahrain</option> |
| 349 <option value="BB">Barbados</option> |
| 350 <option value="BE">Belgium</option> |
| 351 <option value="BZ">Belize</option> |
| 352 <option value="BM">Bermuda</option> |
| 353 <option value="BR">Brazil</option> |
| 354 <option value="CA">Canada</option> |
| 355 <option value="KY">Cayman Islands</option> |
| 356 <option value="CL">Chile</option> |
| 357 <option value="CN">China</option> |
| 358 <option value="CO">Colombia</option> |
| 359 <option value="CR">Costa Rica</option> |
| 360 <option value="DK">Denmark</option> |
| 361 <option value="DO">Dominican Republic</option> |
| 362 <option value="EC">Ecuador</option> |
| 363 <option value="SV">El Salvador</option> |
| 364 <option value="FR">France</option> |
| 365 <option value="DE">Germany</option> |
| 366 <option value="GR">Greece</option> |
| 367 <option value="GU">Guam</option> |
| 368 <option value="GT">Guatemala</option> |
| 369 <option value="HN">Honduras</option> |
| 370 <option value="HK">Hong Kong</option> |
| 371 <option value="IN">India</option> |
| 372 <option value="ID">Indonesia</option> |
| 373 <option value="IE">Ireland</option> |
| 374 <option value="IL">Israel</option> |
| 375 <option value="IT">Italy</option> |
| 376 <option value="JM">Jamaica</option> |
| 377 <option value="JP">Japan</option> |
| 378 <option value="KR">Korea, South</option> |
| 379 <option value="KW">Kuwait</option> |
| 380 <option value="MH">Marshall Islands</option> |
| 381 <option value="MX">Mexico</option> |
| 382 <option value="FM">Micronesia</option> |
| 383 <option value="NL">Netherlands</option> |
| 384 <option value="AN">Netherlands Antilles</option> |
| 385 <option value="NZ">New Zealand</option> |
| 386 <option value="NI">Nicaragua</option> |
| 387 <option value="MP">Northern Mariana Islands</option> |
| 388 <option value="NO">Norway</option> |
| 389 <option value="PW">Palau</option> |
| 390 <option value="PA">Panama</option> |
| 391 <option value="PE">Peru</option> |
| 392 <option value="PH">Philippines</option> |
| 393 <option value="PT">Portugal</option> |
| 394 <option value="PR">Puerto Rico</option> |
| 395 <option value="QA">Qatar</option> |
| 396 <option value="RU">Russia</option> |
| 397 <option value="SG">Singapore</option> |
| 398 <option value="ES">Spain & Canary Islands</option> |
| 399 <option value="SE">Sweden</option> |
| 400 <option value="CH">Switzerland</option> |
| 401 <option value="TW">Taiwan</option> |
| 402 <option value="TH">Thailand</option> |
| 403 <option value="TT">Trinidad and Tobago</option> |
| 404 <option value="TR">Turkey</option> |
| 405 <option value="AE">United Arab Emirates</option> |
| 406 <option value="GB">United Kingdom</option> |
| 407 <option value="US">United States</option> |
| 408 <option value="VN">Vietnam</option> |
| 409 </select></div> |
| 410
</div> |
| 411 </fields
et> |
| 412 |
| 413 </div> |
| 414 <div id="form-vi
saCheckout" class="form-visaCheckout" style="display: none"> |
| 415 <div cla
ss="visa-checkout-selected-info"> |
| 416
<p>You have selected the following payment method:</p> |
| 417 </div> |
| 418 <div> |
| 419
<div id="vcoCardToExpireMsg" class="info-msg"></div> |
| 420
<div id="vcoCardBrandImage"></div> |
| 421
<div id="spinner-visaCheckout-data" class="spinner-container-visa-checkout-data"
style="display: none"> </div> |
| 422
<div class="visa-checkout-data"> |
| 423
<div id="cardNumber"></div> |
| 424
<div><a id="editVisaCheckoutPayment" href="javascript:void(0);">Edit Vis
a Checkout payment</a> | <a id="selectDiffPaymentMethod" href="javascript:void(0
);">Select a different payment method</a></div> |
| 425
<div id="customerEmail"></div> |
| 426
<div class="form-row" style="margin-top: 12px; display: none"> |
| 427
<div id="divWalletCCSecurityCode" class="form-groupset" style="d
isplay: none; visibility: hidden"> |
| 428
<div class="form-group card-security-code"><label class=
"ifl" for="WalletCCSecurityCode">Security code</label><span aria-hidden="true" c
lass="field-validation-valid" data-valmsg-for="WalletCCSecurityCode" data-valmsg
-replace="true"></span><input autocomplete="off" data-privacy="no-capture" id="W
alletCCSecurityCode" maxlength="4" name="WalletCCSecurityCode" type="password" v
alue=""></div> |
| 429
<button type="button" class="icon-tooltip-large-clear-bg
tool-tip-security-code" data-toggle="tooltip" data-tooltip-style="default" tabi
ndex="0" data-hasqtip="4" oldtitle="What's a security code?" title=""><span clas
s="visuallyhidden">About credit card security code</span></button> |
| 430
<div class="tip-security-code"> |
| 431
<div class="tip-security-code-default"> |
| 432
<h6>Security code</h6> |
| 433
<p>The card security code consists of th
e last three digits of the number on the back of your Visa, MasterCard or Discov
er Card, or the four digits above the main number on your American Express card.
</p> |
| 434
</div> |
| 435
<div class="tip-security-code-visa" style="displ
ay: none;"> |
| 436
<h6>Visa - CVV2</h6> |
| 437
<p>The card security code consists of th
e last three digits of the number on the back of your Visa.</p> |
| 438
<img src="https://www.united.com/web/for
mat/img/card/CVV2_Visa.GIF" alt="Visa security code"> |
| 439
</div> |
| 440
<div class="tip-security-code-mc" style="display
: none;"> |
| 441
<h6>MasterCard - CVC2</h6> |
| 442
<p>The card security code consists of th
e last three digits of the number on the back of your MasterCard.</p> |
| 443
<img src="https://www.united.com/web/for
mat/img/card/CVC2_MC.GIF" alt="MasterCard security code"> |
| 444
</div> |
| 445
<div class="tip-security-code-amex" style="displ
ay: none;"> |
| 446
<h6>American Express – CID</h6> |
| 447
<p>The card security code consists of th
e four digits above the main number on your American Express card.</p> |
| 448
<img src="https://www.united.com/web/for
mat/img/card/CID_Amex.GIF" alt="American Express security code"> |
| 449
</div> |
| 450
<div class="tip-security-code-discover" style="d
isplay: none;"> |
| 451
<h6>Discover – CID</h6> |
| 452
<p>The card security code consists of th
e last three digits of the number on the back of your Discover Card.</p> |
| 453
<img src="https://www.united.com/web/for
mat/img/card/CID_Discover.GIF" alt="Discover security code"> |
| 454
</div> |
| 455
</div> |
| 456
</div> |
| 457
</div> |
| 458
</div> |
| 459 </div> |
| 460 </div> |
| 461 <div id="divcash
options"> |
| 462 <fieldse
t class="section-cash-type form-group" style="display: none;"> |
| 463 <p>If you plan to pay with cash, your reservation will be held until midnigh
t CT on Wed, Mar 02, 2016 and must be purchased by that time or the reservation
will be released for another customer to purchase.</p> |
| 464 |
| 465 <legend>Select where you will complete your cash purchase <small class="rqrd
" aria-hidden="true">(*Required)</small></legend> |
| 466 <h4 class="legend">Select where you will complete your cash purchase <small
class="rqrd" aria-hidden="true">(*Required)</small></h4> |
| 467 <div class="form-group group-type-radio group-type-radio-cash"> |
| 468 |
| 469 <div class="form-row"><span aria-hidden="true" class="field-vali
dation-valid" data-valmsg-for="CashType" data-valmsg-replace="true"></span><div
class="radio" id="uniform-CashType_WU"><span><input aria-required="true" class="
type-radio rcashtype preproc" data-number="1" data-val="true" data-val-required=
"Please make a selection.<!--EC:V152-->" id="CashType_WU" name="CashType" tabind
ex="0" type="radio" value="WU"></span></div><label class="radio" for="CashType_W
U">Western Union ($11.95 service charge per transaction)</label></div> |
| 470 <div class="form-row"><div class="radio" id="uniform-CashType_AT
O"><span><input aria-required="true" class="type-radio rcashtype preproc" data-n
umber="2" id="CashType_ATO" name="CashType" tabindex="0" type="radio" value="ATO
"></span></div><label class="radio" for="CashType_ATO">Airport Ticket Office (se
rvice charge per transaction may apply)</label></div> |
| 471 <div class="form-row"><div class="radio" id="uniform-CashType_CT
O"><span><input aria-required="true" class="type-radio rcashtype preproc" data-n
umber="3" id="CashType_CTO" name="CashType" tabindex="0" type="radio" value="CTO
"></span></div><label class="radio" for="CashType_CTO">United Ticket Office (ser
vice charge per transaction may apply)</label></div> |
| 472 </div> |
| 473 </fieldset> |
| 474 </div> |
| 475 |
| 476 |
| 477 |
| 478 |
| 479 |
| 480 <div id="BMLInfo" class="booking-content" style="display: none;"> |
| 481 <p>PayPal Credit is a fast and secure way to pay online without using a
credit card. After your ticket is confirmed, you will receive a billing statemen
t. <a href="https://www.united.com/web/en-US/content/booking/flight/whatIsBML.as
px" target="_blank">Learn more about PayPal Credit</a></p> |
| 482 <div class="form-row"> |
| 483 <span aria-hidden="true" class="field-validation-valid" data-val
msg-for="BmlModel.IfForSixMonthsNoPayment" data-valmsg-replace="true"></span><di
v class="checker" id="uniform-BmlModel_IfForSixMonthsNoPayment"><span><input cla
ss="type-checkbox type-checkbox preproc" data-val="true" data-val-required="The
IfForSixMonthsNoPayment field is required." id="BmlModel_IfForSixMonthsNoPayment
" name="BmlModel.IfForSixMonthsNoPayment" type="checkbox" value="true"></span></
div><input name="BmlModel.IfForSixMonthsNoPayment" type="hidden" value="false"><
label class="checkbox" for="BmlModel_IfForSixMonthsNoPayment">Yes, I would like
to make no payments for six months on orders greater than $250.</label> |
| 484 </div> |
| 485 <fieldset id="PayPal CreditInfo"> |
| 486 <legend class="visuallyhidden">Apply for PayPal Credit <small cl
ass="rqrd" aria-hidden="true">(*Required)</small></legend> |
| 487 <h4 class="legend" aria-hidden="true">Apply for PayPal Credit <s
mall class="rqrd" aria-hidden="true">(*Required)</small></h4> |
| 488 <p>The information entered below will be sent to PayPal Credit.<
/p> |
| 489 <div> |
| 490 <div class="form-row"> |
| 491 <div class="form-group"><label class="ifl" for="
BmlModel_FirstName">First name<em aria-hidden="true" class="rqrd">*</em></label>
<span aria-hidden="true" class="field-validation-valid" data-valmsg-for="BmlMode
l.FirstName" data-valmsg-replace="true"></span><input aria-required="true" data-
val="true" data-val-regex="Please enter a valid First name.<!--EC:V15-->" data-v
al-regex-pattern="[A-Za-z]{1,}[A-Za-z -]{0,}" data-val-required="Please enter a
First name.<!--EC:V1-->" id="BmlModel_FirstName" name="BmlModel.FirstName" type=
"text" value=""></div> |
| 492 <div class="form-group"><label class="ifl" for="
BmlModel_LastName">Last name<em aria-hidden="true" class="rqrd">*</em></label><s
pan aria-hidden="true" class="field-validation-valid" data-valmsg-for="BmlModel.
LastName" data-valmsg-replace="true"></span><input aria-required="true" data-val
="true" data-val-regex="Please enter a valid Last name.<!--EC:V15-->" data-val-r
egex-pattern="[A-Za-z]{2,}[A-Za-z -]{0,}" data-val-required="Please enter a Last
name.<!--EC:V1-->" id="BmlModel_LastName" name="BmlModel.LastName" type="text"
value=""></div> |
| 493 </div> |
| 494 <div id="guestBML"> |
| 495 <div class="form-row"> |
| 496 <div class="form-group bml-addre
ss-line"><label class="ifl" for="BmlModel_BMLAddressLine1">Billing address<em ar
ia-hidden="true" class="rqrd">*</em></label><span aria-hidden="true" class="fiel
d-validation-valid" data-valmsg-for="BmlModel.BMLAddressLine1" data-valmsg-repla
ce="true"></span><input aria-required="true" data-val="true" data-val-required="
Please enter a Billing address.<!--EC:V1-->" id="BmlModel_BMLAddressLine1" name=
"BmlModel.BMLAddressLine1" type="text" value=""></div> |
| 497 </div> |
| 498 <div class="form-row"> |
| 499 <div class="form-group address-c
ity"><label class="ifl" for="BmlModel_BMLCity">City<em aria-hidden="true" class=
"rqrd">*</em></label><span aria-hidden="true" class="field-validation-valid" dat
a-valmsg-for="BmlModel.BMLCity" data-valmsg-replace="true"></span><input aria-re
quired="true" data-val="true" data-val-length="The field City must be a string w
ith a maximum length of 30." data-val-length-max="30" data-val-regex="Please ent
er a valid City.<!--EC:V15-->" data-val-regex-pattern="[A-Za-z., \-]{2,}" data-v
al-required="Please enter a City.<!--EC:V1-->" id="BmlModel_BMLCity" maxlength="
30" name="BmlModel.BMLCity" type="text" value=""></div> |
| 500 <div class="form-group address-s
tate"><label class="ifl" for="BmlModel_BMLStateCode">State/territory/province<em
aria-hidden="true" class="rqrd">*</em></label><span aria-hidden="true" class="f
ield-validation-valid" data-valmsg-for="BmlModel.BMLStateCode" data-valmsg-repla
ce="true"></span><input aria-required="true" data-val="true" data-val-required="
Please enter a State/territory/province.<!--EC:V1-->" id="BmlModel_BMLStateCode"
name="BmlModel.BMLStateCode" type="text" value=""></div> |
| 501 <div class="form-group bml-addre
ss-post-code"><label class="ifl" for="BmlModel_BMLPostalCode">Zip/Postal code<em
aria-hidden="true" class="rqrd">*</em></label><span aria-hidden="true" class="f
ield-validation-valid" data-valmsg-for="BmlModel.BMLPostalCode" data-valmsg-repl
ace="true"></span><input aria-required="true" data-val="true" data-val-length="T
he field Zip/Postal code must be a string with a maximum length of 10." data-val
-length-max="10" data-val-regex="Please enter a valid Zip/Postal code.<!--EC:V15
-->" data-val-regex-pattern="[abcdefghijklmnopqrstuvwxyzABCDEFGHIJKLMNOPQRSTUVWX
YZ0123456789 ,///-]{1,}" data-val-required="Please enter a Zip/Postal code.<!--E
C:V1-->" id="BmlModel_BMLPostalCode" maxlength="10" name="BmlModel.BMLPostalCode
" type="text" value=""></div> |
| 502 </div> |
| 503 <h4 id="countryDescription" class="legen
d"></h4> |
| 504 <div id="divBMLGuestPhoneInputFields" st
yle="display:"> |
| 505 <div class="form-row"> |
| 506 <div class="form-group"> |
| 507 <div class="grou
p-label">Phone prefix<em class="rqrd" aria-hidden="true">*</em></div> |
| 508 <label for="BmlM
odel_BMLPhoneCountryAccessCode" class="visuallyhidden">Phone Country</label> |
| 509 <div class="sele
ctor fixedWidth" id="uniform-BmlModel_BMLPhoneCountryAccessCode"><span aria-hidd
en="true" style="-webkit-user-select: none;">United States</span><select id="Bml
Model_BMLPhoneCountryAccessCode" name="BmlModel.BMLPhoneCountryAccessCode" class
="preproc"><option value="US">United States</option> |
| 510 <option value="CA">Canada</option> |
| 511 <option value="GB">United Kingdom</option> |
| 512 <option value="AF">Afghanistan</option> |
| 513 <option value="AL">Albania</option> |
| 514 <option value="DZ">Algeria</option> |
| 515 <option value="AS">American Samoa</option> |
| 516 <option value="AD">Andorra</option> |
| 517 <option value="AO">Angola</option> |
| 518 <option value="AI">Anguilia</option> |
| 519 <option value="AQ">Antarctica</option> |
| 520 <option value="AG">Antigua and Barbuda</option> |
| 521 <option value="AR">Argentina</option> |
| 522 <option value="AM">Armenia</option> |
| 523 <option value="AW">Aruba</option> |
| 524 <option value="AU">Australia</option> |
| 525 <option value="AT">Austria</option> |
| 526 <option value="AZ">Azerbaijan</option> |
| 527 <option value="BS">Bahamas</option> |
| 528 <option value="BH">Bahrain</option> |
| 529 <option value="BD">Bangladesh</option> |
| 530 <option value="BB">Barbados</option> |
| 531 <option value="BY">Belarus</option> |
| 532 <option value="BE">Belgium</option> |
| 533 <option value="BZ">Belize</option> |
| 534 <option value="BJ">Benin</option> |
| 535 <option value="BM">Bermuda</option> |
| 536 <option value="BT">Bhutan</option> |
| 537 <option value="BO">Bolivia</option> |
| 538 <option value="BQ">Bonaire, Sint Eustatius and Saba</option> |
| 539 <option value="BA">Bosnia and Herzegovina</option> |
| 540 <option value="BW">Botswana</option> |
| 541 <option value="BR">Brazil</option> |
| 542 <option value="IO">British Indian Ocean Territory</option> |
| 543 <option value="VG">British Virgin Islands</option> |
| 544 <option value="BN">Brunei</option> |
| 545 <option value="BG">Bulgaria</option> |
| 546 <option value="BF">Burkina Faso</option> |
| 547 <option value="BI">Burundi</option> |
| 548 <option value="KH">Cambodia</option> |
| 549 <option value="CM">Cameroon</option> |
| 550 <option value="CV">Cape Verde</option> |
| 551 <option value="KY">Cayman Islands</option> |
| 552 <option value="CF">Central African Republic</option> |
| 553 <option value="TD">Chad</option> |
| 554 <option value="CL">Chile</option> |
| 555 <option value="CN">China, People's Republic of</option> |
| 556 <option value="CX">Christmas Island</option> |
| 557 <option value="CC">Cocos (Keeling) Islands</option> |
| 558 <option value="CO">Colombia</option> |
| 559 <option value="KM">Comoros</option> |
| 560 <option value="CG">Congo</option> |
| 561 <option value="CD">Congo, Democratic Republic of the (Zaire)</option> |
| 562 <option value="CK">Cook Islands</option> |
| 563 <option value="CR">Costa Rica</option> |
| 564 <option value="CI">Cote d'ivoire</option> |
| 565 <option value="HR">Croatia</option> |
| 566 <option value="CU">Cuba</option> |
| 567 <option value="CW">Curaçao</option> |
| 568 <option value="CY">Cyprus</option> |
| 569 <option value="CZ">Czech Republic</option> |
| 570 <option value="DK">Denmark</option> |
| 571 <option value="DG">Diego Garcia</option> |
| 572 <option value="DJ">Djibouti</option> |
| 573 <option value="DM">Dominica</option> |
| 574 <option value="DO">Dominican Republic</option> |
| 575 <option value="TP">East Timor</option> |
| 576 <option value="EC">Ecuador</option> |
| 577 <option value="EG">Egypt</option> |
| 578 <option value="SV">El Salvador</option> |
| 579 <option value="GQ">Equatorial Guinea</option> |
| 580 <option value="ER">Eritrea</option> |
| 581 <option value="EE">Estonia</option> |
| 582 <option value="ET">Ethiopia</option> |
| 583 <option value="FK">Falkland Islands</option> |
| 584 <option value="FO">Faroe Islands</option> |
| 585 <option value="FJ">Fiji</option> |
| 586 <option value="FI">Finland</option> |
| 587 <option value="FR">France</option> |
| 588 <option value="GF">French Guiana</option> |
| 589 <option value="PF">French Polynesia</option> |
| 590 <option value="GA">Gabon</option> |
| 591 <option value="GM">Gambia</option> |
| 592 <option value="GE">Georgia</option> |
| 593 <option value="DE">Germany</option> |
| 594 <option value="GH">Ghana</option> |
| 595 <option value="GI">Gibraltar</option> |
| 596 <option value="GR">Greece</option> |
| 597 <option value="GL">Greenland</option> |
| 598 <option value="GD">Grenada</option> |
| 599 <option value="GP">Guadeloupe</option> |
| 600 <option value="GU">Guam</option> |
| 601 <option value="GT">Guatemala</option> |
| 602 <option value="GN">Guinea</option> |
| 603 <option value="GW">Guinea-Bissau</option> |
| 604 <option value="GY">Guyana</option> |
| 605 <option value="HT">Haiti</option> |
| 606 <option value="HN">Honduras</option> |
| 607 <option value="HK">Hong Kong</option> |
| 608 <option value="HU">Hungary</option> |
| 609 <option value="IS">Iceland</option> |
| 610 <option value="IN">India</option> |
| 611 <option value="ID">Indonesia</option> |
| 612 <option value="IR">Iran</option> |
| 613 <option value="IQ">Iraq</option> |
| 614 <option value="IE">Ireland</option> |
| 615 <option value="IL">Israel</option> |
| 616 <option value="IT">Italy</option> |
| 617 <option value="JM">Jamaica</option> |
| 618 <option value="JP">Japan</option> |
| 619 <option value="JO">Jordan</option> |
| 620 <option value="KZ">Kazakhstan</option> |
| 621 <option value="KE">Kenya</option> |
| 622 <option value="KI">Kiribati</option> |
| 623 <option value="KP">Korea, North</option> |
| 624 <option value="KR">Korea, South</option> |
| 625 <option value="KW">Kuwait</option> |
| 626 <option value="KG">Kyrgyzstan</option> |
| 627 <option value="LA">Laos</option> |
| 628 <option value="LV">Latvia</option> |
| 629 <option value="LB">Lebanon</option> |
| 630 <option value="LS">Lesotho</option> |
| 631 <option value="LR">Liberia</option> |
| 632 <option value="LY">Libya</option> |
| 633 <option value="LI">Liechtenstein</option> |
| 634 <option value="LT">Lithuania</option> |
| 635 <option value="LU">Luxembourg</option> |
| 636 <option value="MO">Macau</option> |
| 637 <option value="MK">Macedonia (FYROM)</option> |
| 638 <option value="MG">Madagascar</option> |
| 639 <option value="MW">Malawi</option> |
| 640 <option value="MY">Malaysia</option> |
| 641 <option value="MV">Maldives</option> |
| 642 <option value="ML">Mali</option> |
| 643 <option value="MT">Malta</option> |
| 644 <option value="MH">Marshall Islands</option> |
| 645 <option value="MQ">Martinique</option> |
| 646 <option value="MR">Mauritania</option> |
| 647 <option value="MU">Mauritius</option> |
| 648 <option value="YT">Mayotte</option> |
| 649 <option value="MX">Mexico</option> |
| 650 <option value="FM">Micronesia</option> |
| 651 <option value="MD">Moldova</option> |
| 652 <option value="MC">Monaco</option> |
| 653 <option value="MN">Mongolia</option> |
| 654 <option value="ME">Montenegro</option> |
| 655 <option value="MS">Montserrat</option> |
| 656 <option value="MA">Morocco</option> |
| 657 <option value="MZ">Mozambique</option> |
| 658 <option value="MM">Myanmar (Burma)</option> |
| 659 <option value="NA">Namibia</option> |
| 660 <option value="NR">Nauru</option> |
| 661 <option value="NP">Nepal</option> |
| 662 <option value="NL">Netherlands</option> |
| 663 <option value="NC">New Caledonia</option> |
| 664 <option value="NZ">New Zealand</option> |
| 665 <option value="NI">Nicaragua</option> |
| 666 <option value="NE">Niger</option> |
| 667 <option value="NG">Nigeria</option> |
| 668 <option value="NU">Niue</option> |
| 669 <option value="NF">Norfolk Island</option> |
| 670 <option value="MP">Northern Mariana Islands</option> |
| 671 <option value="NO">Norway</option> |
| 672 <option value="OM">Oman</option> |
| 673 <option value="PK">Pakistan</option> |
| 674 <option value="PW">Palau</option> |
| 675 <option value="PS">Palestinian Territories</option> |
| 676 <option value="PA">Panama</option> |
| 677 <option value="PG">Papua New Guinea</option> |
| 678 <option value="PY">Paraguay</option> |
| 679 <option value="PE">Peru</option> |
| 680 <option value="PH">Philippines</option> |
| 681 <option value="PN">Pitcairn</option> |
| 682 <option value="PL">Poland</option> |
| 683 <option value="PT">Portugal</option> |
| 684 <option value="PR">Puerto Rico</option> |
| 685 <option value="QA">Qatar</option> |
| 686 <option value="RE">Reunion</option> |
| 687 <option value="RO">Romania</option> |
| 688 <option value="RU">Russia</option> |
| 689 <option value="RW">Rwanda</option> |
| 690 <option value="GS">South Georgia and the South Sandwich Islands</option> |
| 691 <option value="BL">Saint Barthélemy</option> |
| 692 <option value="KN">Saint Kitts and Nevis</option> |
| 693 <option value="LC">Saint Lucia</option> |
| 694 <option value="MF">Saint Martin (France)</option> |
| 695 <option value="VC">Saint Vincent and the Grenadines</option> |
| 696 <option value="WS">Samoa</option> |
| 697 <option value="SM">San Marino</option> |
| 698 <option value="ST">Sao Tome and Principe</option> |
| 699 <option value="SA">Saudi Arabia</option> |
| 700 <option value="SN">Senegal</option> |
| 701 <option value="RS">Serbia</option> |
| 702 <option value="SC">Seychelles</option> |
| 703 <option value="SL">Sierra Leone</option> |
| 704 <option value="SG">Singapore</option> |
| 705 <option value="SX">Sint Maarten (Netherlands)</option> |
| 706 <option value="SK">Slovakia</option> |
| 707 <option value="SI">Slovenia</option> |
| 708 <option value="SB">Solomon Islands</option> |
| 709 <option value="SO">Somalia</option> |
| 710 <option value="ZA">South Africa</option> |
| 711 <option value="SS">South Sudan</option> |
| 712 <option value="ES">Spain & Canary Islands</option> |
| 713 <option value="LK">Sri Lanka</option> |
| 714 <option value="SH">Saint Helena</option> |
| 715 <option value="PM">Saint Pierre and Miquelon</option> |
| 716 <option value="SD">Sudan</option> |
| 717 <option value="SR">Suriname</option> |
| 718 <option value="SJ">Svalbard and Jan Mayen Islands</option> |
| 719 <option value="SZ">Swaziland</option> |
| 720 <option value="SE">Sweden</option> |
| 721 <option value="CH">Switzerland</option> |
| 722 <option value="SY">Syria</option> |
| 723 <option value="TW">Taiwan</option> |
| 724 <option value="TJ">Tajikistan</option> |
| 725 <option value="TZ">Tanzania</option> |
| 726 <option value="TH">Thailand</option> |
| 727 <option value="TG">Togo</option> |
| 728 <option value="TK">Tokelau</option> |
| 729 <option value="TO">Tonga</option> |
| 730 <option value="TT">Trinidad and Tobago</option> |
| 731 <option value="TN">Tunisia</option> |
| 732 <option value="TR">Turkey</option> |
| 733 <option value="TM">Turkmenistan</option> |
| 734 <option value="TC">Turks and Caicos Islands</option> |
| 735 <option value="TV">Tuvalu</option> |
| 736 <option value="UG">Uganda</option> |
| 737 <option value="UA">Ukraine</option> |
| 738 <option value="AE">United Arab Emirates</option> |
| 739 <option value="UM">United States Minor Outlying Islands</option> |
| 740 <option value="UY">Uruguay</option> |
| 741 <option value="UZ">Uzbekistan</option> |
| 742 <option value="VU">Vanuatu</option> |
| 743 <option value="VA">Vatican City State (Holy See)</option> |
| 744 <option value="VE">Venezuela</option> |
| 745 <option value="VN">Vietnam</option> |
| 746 <option value="VI">U.S. Virgin Islands</option> |
| 747 <option value="WF">Wallis and Futuna</option> |
| 748 <option value="YE">Yemen</option> |
| 749 <option value="ZM">Zambia</option> |
| 750 <option value="ZW">Zimbabwe</option> |
| 751 </select></div> |
| 752 </div> |
| 753 </div> |
| 754 <div class="form-row"> |
| 755 <div class="form-group">
<label class="ifl" for="BmlModel_BMLPhoneNumber">Phone number<em aria-hidden="tr
ue" class="rqrd">*</em></label><span aria-hidden="true" class="field-validation-
valid" data-valmsg-for="BmlModel.BMLPhoneNumber" data-valmsg-replace="true"></sp
an><input aria-required="true" data-val="true" data-val-regex="Please enter a va
lid Phone number.<!--EC:V15-->" data-val-regex-pattern="[0-9 .+\\()/-]{6,}" data
-val-required="Please enter a Phone number.<!--EC:V1-->" id="BmlModel_BMLPhoneNu
mber" name="BmlModel.BMLPhoneNumber" type="text" value=""></div> |
| 756 <div class="form-group">
<label class="ifl" for="BmlModel_BMLPhoneExtension">Extension (Optional)</label>
<span aria-hidden="true" class="field-validation-valid" data-valmsg-for="BmlMode
l.BMLPhoneExtension" data-valmsg-replace="true"></span><input data-val="true" da
ta-val-regex="Please enter a valid Extension (Optional).<!--EC:V15-->" data-val-
regex-pattern="[A-Za-z0-9 ]+" id="BmlModel_BMLPhoneExtension" name="BmlModel.BML
PhoneExtension" type="text" value=""></div> |
| 757 </div> |
| 758 <div class="form-row"> |
| 759 <div class="form-group"
id="guest-bml-email"><label class="ifl" for="BmlModel_BMLEmail">Email address<em
aria-hidden="true" class="rqrd">*</em></label><span aria-hidden="true" class="f
ield-validation-valid" data-valmsg-for="BmlModel.BMLEmail" data-valmsg-replace="
true"></span><input aria-required="true" data-val="true" data-val-length="The fi
eld Email address must be a string with a maximum length of 75." data-val-length
-max="75" data-val-regex="Please enter a valid Email address.<!--EC:V15-->" data
-val-regex-pattern="^( ?)([\w\.\-_]+)@([\w\-]+)((\.([\w\-]{2,}))?)+$" data-val-r
equired="Please enter a Email address.<!--EC:V1-->" id="BmlModel_BMLEmail" maxle
ngth="75" name="BmlModel.BMLEmail" type="text" value=""></div> |
| 760 </div> |
| 761 </div> |
| 762 <div id="divBMLGuestSelectedPhoneData" c
lass="form-row"></div> |
| 763 </div> |
| 764 |
| 765 </div> |
| 766 <div class="form-row"> |
| 767 For verification purposes , please enter your date of bi
rth and the last four digits of your Social Security Number. |
| 768 </div> |
| 769 <div class="form-row"> |
| 770 <div class="form-group bml-birth-month"> |
| 771 <div class="group-label">Date of birth<em class=
"rqrd" aria-hidden="true">*</em></div> |
| 772 <span aria-hidden="true" class="field-validation
-valid" data-valmsg-for="BmlModel.DobMonth" data-valmsg-replace="true"></span> |
| 773 <label for="BmlModel_DobMonth" class="visuallyhi
dden">Date Of Birth Month</label> |
| 774 <div class="selector fixedWidth" id="uniform-Bml
Model_DobMonth"><span aria-hidden="true" style="-webkit-user-select: none;">Mont
h</span><select data-val="true" data-val-required="Please enter a Month.<!--EC:V
1-->" id="BmlModel_DobMonth" name="BmlModel.DobMonth" class="preproc"><option va
lue="">Month</option> |
| 775 <option value="1">01 - January</option> |
| 776 <option value="2">02 - February</option> |
| 777 <option value="3">03 - March</option> |
| 778 <option value="4">04 - April</option> |
| 779 <option value="5">05 - May</option> |
| 780 <option value="6">06 - June</option> |
| 781 <option value="7">07 - July</option> |
| 782 <option value="8">08 - August</option> |
| 783 <option value="9">09 - September</option> |
| 784 <option value="10">10 - October</option> |
| 785 <option value="11">11 - November</option> |
| 786 <option value="12">12 - December</option> |
| 787 </select></div> |
| 788 </div> |
| 789 <div class="form-group date-day"> |
| 790 <div class="group-label"> </div> |
| 791 <div class="form-group"><label class="ifl" for="
BmlModel_DobDay">DD<em aria-hidden="true" class="rqrd">*</em></label><span aria-
hidden="true" class="field-validation-valid" data-valmsg-for="BmlModel.DobDay" d
ata-valmsg-replace="true"></span><input length="2" aria-required="true" data-val
="true" data-val-regex="Please enter a valid DD.<!--EC:V15-->" data-val-regex-pa
ttern="(0[1-9]|[12]\d|3[01])" data-val-required="Please enter a DD.<!--EC:V1-->"
id="BmlModel_DobDay" name="BmlModel.DobDay" type="text" value=""></div> |
| 792 </div> |
| 793 <div class="form-group bml-birth-year"> |
| 794 <div class="group-label"> </div> |
| 795 <div class="form-group"><label class="ifl" for="
BmlModel_DobYear">YYYY<em aria-hidden="true" class="rqrd">*</em></label><span ar
ia-hidden="true" class="field-validation-valid" data-valmsg-for="BmlModel.DobYea
r" data-valmsg-replace="true"></span><input length="4" aria-required="true" data
-val="true" data-val-range="Date of Birth year cannot be greater than cuurent ye
ar." data-val-range-max="2014" data-val-range-min="1880" data-val-required="Plea
se enter a YYYY.<!--EC:V1-->" id="BmlModel_DobYear" name="BmlModel.DobYear" type
="text" value=""></div> |
| 796 </div> |
| 797 |
| 798 <div class="form-group ssn-last-four"> |
| 799 <div class="group-label">Social Security Number<
em class="rqrd" aria-hidden="true">*</em></div> |
| 800 <span class="ssn-hash">#### - ### -</span> <div
class="form-group"><label class="ifl" for="BmlModel_SocialSN">Last 4 digits<em a
ria-hidden="true" class="rqrd">*</em></label><span aria-hidden="true" class="fie
ld-validation-valid" data-valmsg-for="BmlModel.SocialSN" data-valmsg-replace="tr
ue"></span><input aria-required="true" autocomplete="off" data-privacy="no-captu
re" data-val="true" data-val-regex="Invalid Social Security Number - last 4 digi
ts" data-val-regex-pattern="^\d{4}$" data-val-required="Last 4 digits" id="BmlMo
del_SocialSN" name="BmlModel.SocialSN" type="text" value=""></div> |
| 801 </div> |
| 802 </div> |
| 803 <p>You must read the E-Sign consent of the Terms and Conditions
listed below prior to checking the following box: <a href="https://www.united.co
m/web/en-US/content/booking/flight/FNGENP36.pdf" target="_blank">See E-Sign prin
ter-friendly version</a></p> |
| 804 <div class="form-row"> |
| 805 <div class="form-group group-type-checkbox"> |
| 806 <span aria-hidden="true" class="field-validation
-valid" data-valmsg-for="BmlModel.IfBMLTermsElectronicAccepted" data-valmsg-repl
ace="true"></span><div class="checker" id="uniform-BmlModel_IfBMLTermsElectronic
Accepted"><span><input class="type-checkbox type-checkbox preproc" data-val="tru
e" data-val-mandatory="Please make a selection.<!--EC:V152-->" data-val-required
="The IfBMLTermsElectronicAccepted field is required." id="BmlModel_IfBMLTermsEl
ectronicAccepted" name="BmlModel.IfBMLTermsElectronicAccepted" type="checkbox" v
alue="true"></span></div><input name="BmlModel.IfBMLTermsElectronicAccepted" typ
e="hidden" value="false"><label class="checkbox" for="BmlModel_IfBMLTermsElectro
nicAccepted"></label> |
| 807 <label for="BmlModel_IfBMLTermsElectronicAccepte
d">I agree to have the <a href="https://www.united.com/web/en-US/content/booking
/flight/bmlTerms.aspx" target="_blank">PayPal Credit terms and conditions</a> pr
esented electronically</label> |
| 808 <div class="inline-validation-msg"></div> |
| 809 </div> |
| 810 </div> |
| 811 <div class="form-row "> |
| 812 <div> |
| 813 <iframe src="https://www.securecheckout.billmela
ter.com/paycapture-content/fetch?hash=AU631DB5&content=/bmlweb/bmlwebtnc_ifr
ame.html" width="100%" height="100%" class="terms"></iframe> |
| 814 </div> |
| 815 </div> |
| 816 <div class="form-row"> |
| 817 <div class="form-group group-type-checkbox"> |
| 818 <span aria-hidden="true" class="field-validation
-valid" data-valmsg-for="BmlModel.IfBMLTermsAccepted" data-valmsg-replace="true"
></span><div class="checker" id="uniform-BmlModel_IfBMLTermsAccepted"><span><inp
ut class="type-checkbox type-checkbox preproc" data-val="true" data-val-mandator
y="Please make a selection.<!--EC:V152-->" data-val-required="The IfBMLTermsAcce
pted field is required." id="BmlModel_IfBMLTermsAccepted" name="BmlModel.IfBMLTe
rmsAccepted" type="checkbox" value="true"></span></div><input name="BmlModel.IfB
MLTermsAccepted" type="hidden" value="false"><label class="checkbox" for="BmlMod
el_IfBMLTermsAccepted"></label> |
| 819 <label for="BmlModel_IfBMLTermsAccepted">I agree
to the <a href="https://www.united.com/web/en-US/content/booking/flight/bmlTerm
s.aspx" target="_blank">PayPal Credit terms and conditions</a></label> |
| 820 <div class="inline-validation-msg"></div> |
| 821 </div> |
| 822 </div> |
| 823 </fieldset> |
| 824 </div> |
| 825 |
| 826 <div class="panel-body-section"> |
| 827 <fieldset> |
| 828 <legend class="v
isuallyhidden">Purchaser contact information</legend> |
| 829 <h3 class="legen
d">Purchaser contact information</h3> |
| 830 <div id="divEmai
lAddressList" class="form-row" style="display:none"> |
| 831 <div cla
ss="form-group"> |
| 832
<div class="selector fixedWidth" id="uniform-EmailAddressList"><span aria-hidden
="true" style="-webkit-user-select: none;"></span><select id="EmailAddressList"
name="EmailAddressList" class="saved-emails-list-sync preproc" onchange="UA.Acco
unt.EmailList.getSelectedEmailData('#EmailAddressList','','#hdnEmailAddressList'
,'#divEmailAddressList','#divEmailAddressInputFields','#divSelectedEmailAddressD
ata','/ual/en/us/flight-search/book-a-flight/billinginfo/rev/')"></select></div> |
| 833
<input type="hidden" id="hdnEmailAddressList" value="1st"> |
| 834 </div> |
| 835 <div cla
ss="form-group"> |
| 836
<aside>Your email address will be used to contact you about this reservation onl
y.</aside> |
| 837 </div> |
| 838 </div> |
| 839 <div class="form
-row" id="divEmailAddressInputFields" style="display:"> |
| 840 <div cla
ss="form-group"><label class="ifl visuallyhidden" for="PurchaserEmailAddress">Em
ail address<em aria-hidden="true" class="rqrd">*</em></label><span aria-hidden="
true" class="field-validation-valid" data-valmsg-for="PurchaserEmailAddress" dat
a-valmsg-replace="true"></span><input aria-required="true" data-val="true" data-
val-length="Email address must be no more than 75 characters.<!--EC:V142-->" dat
a-val-length-max="75" data-val-regex="Please enter a valid Email address.<!--EC:
V15-->" data-val-regex-pattern="^( ?)([\w\.\-_]+)@([\w\-]+)((\.([\w\-]{2,}))?)+$
" data-val-required="Please enter a Email address.<!--EC:V1-->" id="PurchaserEma
ilAddress" maxlength="75" name="PurchaserEmailAddress" type="text" value="homer.
simpson.duffman@gmail.com"></div> |
| 841 <div cla
ss="form-group"> |
| 842
<aside>Your email address will be used to contact you about this reservation onl
y.</aside> |
| 843 </div> |
| 844 </div> |
| 845 <ul id="divSelec
tedEmailAddressData" class="field-edit-links"> |
| 846 <li><a h
ref="#" class="btn-edit-email">Edit email address</a></li> |
| 847 <li><a h
ref="#" class="btn-add-email">Add new email address</a></li> |
| 848 </ul> |
| 849 <div id="divPhon
eList" class="form-row" style="display:none"> |
| 850 <div cla
ss="selector fixedWidth" id="uniform-PhoneList"><span aria-hidden="true" style="
-webkit-user-select: none;"></span><select id="PhoneList" name="PhoneList" class
="saved-phones-list-sync preproc" onchange="UA.Account.PhoneList.getSelectedPhon
eData('#PhoneList','','#hdnPhoneList','#divPhoneList','#divPhoneInputFields','#d
ivSelectedPhoneData','/ual/en/us/flight-search/book-a-flight/billinginfo/rev/')"
></select></div> |
| 851 <input t
ype="hidden" id="hdnPhoneList" value="1st"> |
| 852 </div> |
| 853 <div id="divPhon
eInputFields" style="display:"> |
| 854 <div cla
ss="form-row"> |
| 855
<div class="form-group"><span aria-hidden="true" class="field-validation-valid"
data-valmsg-for="PhoneCountryCode" data-valmsg-replace="true"></span><div class=
"selector fixedWidth" id="uniform-PhoneCountryCode"><span aria-hidden="true" sty
le="-webkit-user-select: none;">United States</span><label class="ifl visuallyhi
dden" for="PhoneCountryCode">Country</label><select aria-label="Country" class="
phone-country-list preproc" id="PhoneCountryCode" name="PhoneCountryCode"><optio
n value=""></option> |
| 856 <option selected="selected" value="US">United States</option> |
| 857 <option value="CA">Canada</option> |
| 858 <option value="GB">United Kingdom</option> |
| 859 <option value="AF">Afghanistan</option> |
| 860 <option value="AL">Albania</option> |
| 861 <option value="DZ">Algeria</option> |
| 862 <option value="AS">American Samoa</option> |
| 863 <option value="AD">Andorra</option> |
| 864 <option value="AO">Angola</option> |
| 865 <option value="AI">Anguilia</option> |
| 866 <option value="AQ">Antarctica</option> |
| 867 <option value="AG">Antigua and Barbuda</option> |
| 868 <option value="AR">Argentina</option> |
| 869 <option value="AM">Armenia</option> |
| 870 </select></div></div> |
| 871 </div> |
| 872 </div> |
| 873 </fieldset> |
| 874 </div> |
| 875 </div> |
| 876 <input id="CartId" name="CartId" type="hidden" value="83029498-98C8-4043-AA9B-10
6E1F89C4BF"><input id="PageError" name="PageError" type="hidden" value="False"><
input id="TripInsurancePurchased" name="TripInsurancePurchased" type="hidden" va
lue="False"><input id="AdditionalData" name="AdditionalData" type="hidden" value
=""></form> |
| OLD | NEW |