<form name="pg_frm" method="post" action="https://www.paygol.com/pay" >
   <input type="hidden" name="pg_serviceid" value="90870">
   <input type="hidden" name="pg_currency" value="EUR">
   <input type="hidden" name="pg_name" value="Fliphotell Diamonds">
   <input type="hidden" name="pg_custom" value="">
   <input type="hidden" name="pg_price" value="3">
   <input type="hidden" name="pg_return_url" value="http://fliphotel.org/shoppen">
   <input type="hidden" name="pg_cancel_url" value="">
   <input type="image" name="pg_button" src="https://www.paygol.com/micropayment/buttons/en/red.png" border="0" alt="Make payments with PayGol: the easiest way!" title="Make payments with PayGol: the easiest way!" >
</form>