Offline Payment Instructions

<form target="paypal" action="" method="post">
<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="85LHQPYP4T8CG">
<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>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" src="" width="1" height="1">
  • Bank Name:
  • Account Number:
  • Account Holder Name: