<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="2UDUZGEUN52C6">
<table>
<tr><td><input type="hidden" name="on0" value="Contribution Suggestions">Contribution Suggestions</td></tr><tr><td><select name="os0">
    <option value="Booster">Booster : $100.00 CAD - monthly</option>
    <option value="Supporter">Supporter : $200.00 CAD - monthly</option>
    <option value="Enthusiast">Enthusiast : $500.00 CAD - monthly</option>
    <option value="Partner">Partner : $1,000.00 CAD - monthly</option>
</select> </td></tr>
</table>
<input type="hidden" name="currency_code" value="CAD">
<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!">
<img alt="" border="0" src="https://www.paypalobjects.com/en_US/i/scr/pixel.gif" width="1" height="1">
</form>