<form action="https://www.paypal.com/cgi-bin/webscr" method="post" target="_top"><!-- [et_pb_line_break_holder] --><input type="hidden" name="cmd" value="_s-xclick"><!-- [et_pb_line_break_holder] --><input type="hidden" name="hosted_button_id" value="6L6QT2AMQJS5C"><!-- [et_pb_line_break_holder] --><table><!-- [et_pb_line_break_holder] --><tr><td><input type="hidden" name="on0" value="Donation options">Donation options</td></tr><tr><td><select name="os0"><!-- [et_pb_line_break_holder] --><option value="Option 1">Option 1 : $10.00 USD - monthly</option><!-- [et_pb_line_break_holder] --><option value="Option 2">Option 2 : $18.00 USD - monthly</option><!-- [et_pb_line_break_holder] --><option value="Option 3">Option 3 : $36.00 USD - monthly</option><!-- [et_pb_line_break_holder] --></select> </td></tr><!-- [et_pb_line_break_holder] --></table><!-- [et_pb_line_break_holder] --><input type="hidden" name="currency_code" value="USD"><!-- [et_pb_line_break_holder] --><input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_subscribeCC_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!"><!-- [et_pb_line_break_holder] --><img alt="" border="0" src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1" height="1"><!-- [et_pb_line_break_holder] --></form>