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<body>
<p>
Please fill out the form below to make a recurring donation via PayPal:
</p>
<form action="https://www.paypal.com/cgi-bin/webscr" id="pp" onsubmit="return checkform(this);" method="post"><input name="t3" type="hidden" value="M"> <input name="p3" type="hidden" value="1"> <input type="hidden" name="item_number" value="Recurring Donation to Galloway Memorial United Methodist Church"> <input name="item_name" type="hidden" value="Recurring Donation to Galloway Memorial United Methodist Church"> <input type="hidden" name="cmd" value="_xclick-subscriptions">
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<table border="0" style="border-collapse: collapse" width="285" cellpadding="5" id="table1" bgcolor="#F2F2F2">
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<td width="172">
Amount:
</td>
<td width="93">
<font size="2"> $</font><input name="a3" size="7" style="width:70px">
</td>
</tr>
<tr>
<td width="172">
Number of recurring months:
</td>
<td width="93">
<select name="srt" size="1">
<option value="" selected>Months</option>
<option value="1">1</option>
<option value="2">2</option>
<option value="3">3</option>
<option value="4">4</option>
<option value="5">5</option>
<option value="6">6</option>
<option value="7">7</option>
<option value="8">8</option>
<option value="9">9</option>
<option value="10">10</option>
<option value="11">11</option>
<option value="12">12</option>
<option value="13">13</option>
<option value="14">14</option>
<option value="15">15</option>
<option value="16">16</option>
<option value="17">17</option>
<option value="18">18</option>
<option value="19">19</option>
<option value="20">20</option>
<option value="21">21</option>
<option value="22">22</option>
<option value="23">23</option>
<option value="24">24</option></select>
</td>
</tr>
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<td colspan="2">
<p align="center">
<input type="image" src="https://www.paypal.com/en_US/i/btn/btn_donate_LG.gif" border="0" name="submit" onsubmit="return checkform(this);" alt="PayPal - The safer, easier way to pay online!">
</p>
</td>
</tr>
</table>
</div>
<input name="no_note" type="hidden" value="1"><input type="hidden" name="src" value="1"><input name="business" type="hidden" value="kslark@gallowayumc.org"> </form>
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