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<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
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<td width="570"><p><span class="style1">Thank you...<br />
You have successfully pre-registered and will receive an email confirmation.</span></p>
<p><span class="style2">To complete your registration, please select below and continue with payment.<br />
</span><span class="style4">(You can change the quantities on the next screen) </span></p>
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<td width="412" bgcolor="#F2F2F2"><span class="style1"><strong>Select options </strong></span></td>
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<td class="style31 style5 style6">test $.01</td>
<td><form target="paypal" action="https://www.paypal.com/cgi-bin/webscr" method="post">
<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="72AHBNRESPG7Q">
<table>
<tr><td><input type="hidden" name="on0" value="Name of drop-down menu">Name of drop-down menu</td></tr><tr><td><select name="os0">
<option value="Option 1">Option 1 $0.01 USD</option>
<option value="Option 2">Option 2 $0.02 USD</option>
<option value="Option 3">Option 3 $0.03 USD</option>
</select> </td></tr>
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<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1" height="1">
</form>
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