<form action="https://www.paypal.com/cgi-bin/webscr" method="post" target="_top">
<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="3KQVDQ8XHWT3J">
<table>
<tr><td><input type="hidden" name="on0" value="VIP GOLD">VIP GOLD</td></tr><tr><td><select name="os0">
	<option value="1 mes VIP">1 mes VIP $10.00 USD</option>
	<option value="2 meses VIP">2 meses VIP $18.00 USD</option>
	<option value="3 meses VIP">3 meses VIP $25.00 USD</option>
	<option value="5 meses VIP">5 meses VIP $40.00 USD</option>
</select> </td></tr>
<tr><td><input type="hidden" name="on1" value="Cuenta (ID)">Cuenta (ID)</td></tr><tr><td><input type="text" name="os1" maxlength="200"></td></tr>
</table>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypalobjects.com/es_XC/i/btn/btn_buynowCC_LG.gif" border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" src="https://www.paypalobjects.com/es_XC/i/scr/pixel.gif" width="1" height="1">
</form>