Ticket Sales

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Diabetes Fundraiser
Nov. 4, 2017

<iframe src="https://docs.google.com/forms/d/e/1FAIpQLSdmUD1xyKsKn4AUDhLJo4tvnCwGmru8awLrN30lkFF5Qh9dSw/viewform?embedded=true" width="640" height="3370" frameborder="0" marginheight="0" marginwidth="0">Loading…</iframe>

<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="EBD578GXVGRXY">
<table>
<tr><td><input type="hidden" name="on0" value="Painting Sign ">
<option value="Painting fee + service fee">Payment for one sign+ service fee $51.00 USD</option>
</select> </td></tr>
<tr><td><input type="hidden" name="on1" value="Name/Phone:">Name/Phone:</td></tr><tr><td><input type="text" name="os1" maxlength="200"></td></tr>
<tr><td><input type="hidden" name="on2" value="Comments:">Comments:</td></tr><tr><td><input type="text" name="os2" maxlength="200"></td></tr>
</table>
<input type="hidden" name="currency_code" value="USD">
<input type="image" src="https://www.paypalobjects.com/en_US/i/btn/btn_paynowCC_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>
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