<form 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="DCL69UHNCJMHQ">
<table>
<tr><td><input type="hidden" name="on0" value="Country of Residence of Gift Recipient">Country of Residence of Gift Recipient</td></tr><tr><td><select name="os0">
    <option value="Israel">Israel $3.50</option>
    <option value="US 48 Continental">US 48 Continental $5.00</option>
    <option value="Hawaii/Alaska">Hawaii/Alaska $5.50</option>
    <option value="Canada">Canada $5.00</option>
    <option value="European Continent">European Continent $5.00</option>
    <option value="Asia/Africa/Asia">Asia/Africa/Asia $6.00</option>
</select> </td></tr>
<tr><td><input type="hidden" name="on1" value="Scents">Scents</td></tr><tr><td><select name="os1">
    <option value="Love Potion">Love Potion </option>
    <option value="Fruity Passions">Fruity Passions </option>
    <option value="Pie Scents">Pie Scents </option>
    <option value="Jewish Saturday Night Special">Jewish Saturday Night Special </option>
    <option value="Surprise Surprise (Changes with Season)">Surprise Surprise (Changes with Season) </option>
</select> </td></tr>
<tr><td><input type="hidden" name="on2" value="Include a short mesage">Include a short mesage</td></tr><tr><td><input type="text" name="os2" maxlength="60"></td></tr>
<tr><td><input type="hidden" name="on3" value="of up to 60 characters">of up to 60 characters</td></tr><tr><td><input type="text" name="os3" maxlength="60"></td></tr>
</table>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypal.com/en_US/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.paypal.com/en_US/i/scr/pixel.gif" width="1" height="1">
</form>


--
Nofia Vered Shem-Tov

"...everything can be taken from a man but one thing: the last of the human freedoms -
to choose one's attitude in any given set of circumstances, to choose one's own way."
-- Viktor E. Frankl, Man's Search For Meaning