​<form action="https://www.paypal.com/cgi-bin/webscr" method="post" target="_blank"> <input type="hidden" name="cmd" value="_s-xclick" /> <input type="hidden" name="hosted_button_id" value="8E2ELCQ9S96V4" /> <table> <tr> <td> <input type="hidden" name="on0" value="Date of Performance"/> Date of Performance </td> </tr> <tr> <td> <select name="os0"> <option value="Saturday, December 2 7:30pm"> Saturday, December 2 7:30pm </option> <option value="Sunday, December 3 2:00pm"> Sunday, December 3 2:00pm </option> </select> </td> </tr> </table> <input type="hidden" name="currency_code" value="USD" /> <input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif" border="0" name="submit" title="PayPal - The safer, easier way to pay online!" alt="Add to Cart" /> </form>