diff --git a/form/rpnAskNameAndCard.tmpl b/form/rpnAskNameAndCard.tmpl
new file mode 100644
index 0000000..bb53597
--- /dev/null
+++ b/form/rpnAskNameAndCard.tmpl
@@ -0,0 +1,14 @@
+{{ define "rpnAskNameAndCard" }}
+  {{ template "Header" }}
+    {{ template "Menu" }} 
+   <h2></h2>  
+    <form method="POST" action="rpnNameAndCard">
+      <input type="hidden" name="uid" value="{{ .Id }}" />
+      <label> 账户姓名 </label><input type="text" name="name" value="zhang3"  /><br />
+      <label> 银行卡号 </label><input type="text" name="card" value="6212262002002377849"  /><br />
+      <input type=hidden name="id", value="{{.id}}" />
+      <input type=hidden name="si" value="{{.signature}}" />
+      <input type="submit" value="下一步" />
+    </form><br />    
+  {{ template "Footer" }}
+{{ end }}