<link href="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/css/bootstrap.min.css" rel="stylesheet" id="bootstrap-css"> <script src="//maxcdn.bootstrapcdn.com/bootstrap/3.3.0/js/bootstrap.min.js"></script> <script src="//cdnjs.cloudflare.com/ajax/libs/jquery/3.2.1/jquery.min.js"></script> <!------ Include the above in your HEAD tag ----------> <div class="container"> <div class="row"> <form action="https://www.paypal.com/cgi-bin/webscr" method="post" target="_top" class="col-md-6 col-lg-6"> <input type="hidden" name="cmd" value="_s-xclick" /> <input type="hidden" name="hosted_button_id" value="K3VBKBECZ7PC6" /> <fieldset> <!-- Select Basic --> <div class="form-group"> <input type="hidden" name="on0" value="Please click the drop down menu to select your " /> <label class="control-label" for="os0">Please click the drop down menu to select your "FALL Services"</label> <select id="os0" name="os0" class="form-control"> <option value="Aeration - DEEP PLUG!!">Aeration - DEEP PLUG!! $40.00 USD</option> <option value="Winterizer - Richlawn Organic Winterizer">Winterizer - Richlawn Organic Winterizer $40.00 USD</option> <option value="GROUND PREP PACKAGE (Includes Aeration & Winterizer)">GROUND PREP PACKAGE (Includes Aeration & Winterizer) $75.00 USD</option> <option value="FALL Overseeding">FALL Overseeding $100.00 USD</option> <option value="REGENERATION PACKAGE (Includes Aeration,Winterizer,Overseed)">REGENERATION PACKAGE (Includes Aeration,Winterizer,Overseed) $150.00 USD</option> <option value="Sprinkler Blow Out">Sprinkler Blow Out $50.00 USD</option> <option value="Gutter Clean Out (1st Story Only)">Gutter Clean Out (1st Story Only) $75.00 USD</option> <option value="Leaf & Stick Clean Up (90 minutes, change quantity for big jobs)">Leaf & Stick Clean Up (90 minutes, change quantity for big jobs) $75.00 USD</option> <option value="Hand Pulling of Weeds (90 minutes)">Hand Pulling of Weeds (90 minutes) $75.00 USD</option> <option value="Bush Trimming (90 minutes, under 6 feet tall only)">Bush Trimming (90 minutes, under 6 feet tall only) $75.00 USD</option> </select> </div> <!-- Select Basic --> <div class="form-group"> <input type="hidden" name="on1" value="Please select your " /> <label class="control-label" for="os1">Please select your "Week of Service"</label> <select id="os1" name="os1" class="form-control"> <option value="December 17 - December 21">December 17 - December 21</option> </select> </div> <!-- Text input--> <div class="form-group"> <input type="hidden" name="on2" value="Type in Property Address" /> <label class="control-label" for="os2">Type in Property Address</label> <input maxlength="200" id="os2" name="os2" type="text" placeholder="placeholder" class="form-control input-md"> </div> <!-- Text input--> <div class="form-group"> <input type="hidden" name="on3" value="Type in Special Instructions" /> <label class="control-label" for="os3">Type in Special Instructions</label> <input maxlength="200" id="os3" name="os3" type="text" placeholder="placeholder" class="form-control input-md"> </div> <!-- Begin Official PayPal Seal --> <strong><a href="https://www.paypal.com/us/verified/pal=grassbusters%2eemail%40gmail%2ecom" target="_blank"><img src="https://www.paypal.com/en_US/i/icon/verification_seal.gif" alt="Official PayPal Seal" border="0" /></a> <input type="hidden" name="currency_code" value="USD" /> <input type="image" name="submit" src="https://www.paypalobjects.com/en_US/i/btn/btn_paynowCC_LG.gif" 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" /> </strong> <!-- End Official PayPal Seal --> </fieldset> </form> </div> </div>