<p>
	<font size="3"><b>Membership Payment Information</b></font>
</p>

<p>
	<font size="3"><b><font size="2">Payment Online</font></b></font>
</p>

<p>
	&nbsp;
</p>

<form action="https://checkout.google.com/api/checkout/v2/checkoutForm/Merchant/206633256322892" id="BB_BuyButtonForm" method="post" name="BB_BuyButtonForm">
	<table cellpadding="7" cellspacing="0" width="1%">
		<tbody>
			<tr>
				<td align="right" width="1%">
					<select name="item_selection_1"><option value="1">Please Verify Membership Level</option><option value="1">$20.00 - Individual</option><option value="2">$25.00 - Individual + Canine</option><option value="3">$40.00 - Household</option><option value="4">$45.00 - Household + Canine</option><option value="5">$50.00 - Why not ?!?</option><option value="6">$100.00 - Sponsor</option><option value="7">$100.00 - Corporate</option> </select>

					<p>
						<input name="item_option_name_1" type="hidden" value="Individual" /> <input name="item_option_price_1" type="hidden" value="20.0" /> <input name="item_option_description_1" type="hidden" /> <input name="item_option_quantity_1" type="hidden" value="1" /> <input name="item_option_currency_1" type="hidden" value="USD" /><input name="item_option_name_2" type="hidden" value="Individual + Canine" /> <input name="item_option_price_2" type="hidden" value="25.0" /> <input name="item_option_description_2" type="hidden" value="Covers doggie cleanup bags" /> <input name="item_option_quantity_2" type="hidden" value="1" /> <input name="item_option_currency_2" type="hidden" value="USD" /><input name="item_option_name_3" type="hidden" value="Household" /> <input name="item_option_price_3" type="hidden" value="40.0" /> <input name="item_option_description_3" type="hidden" /> <input name="item_option_quantity_3" type="hidden" value="1" /> <input name="item_option_currency_3" type="hidden" value="USD" /> <input name="item_option_name_4" type="hidden" value="Household + Canine" /> <input name="item_option_price_4" type="hidden" value="45.0" /> <input name="item_option_description_4" type="hidden" value="Cover doggie cleanup bags" /> <input name="item_option_quantity_4" type="hidden" value="1" /> <input name="item_option_currency_4" type="hidden" value="USD" /> <input name="item_option_name_5" type="hidden" value="Why Not ?!?" /> <input name="item_option_price_5" type="hidden" value="50.0" /> <input name="item_option_description_5" type="hidden" /> <input name="item_option_quantity_5" type="hidden" value="1" /> <input name="item_option_currency_5" type="hidden" value="USD" /> <input name="item_option_name_6" type="hidden" value="Sponsor" /> <input name="item_option_price_6" type="hidden" value="100.0" /> <input name="item_option_description_6" type="hidden" value="Includes 2 House Tour tickets" /> <input name="item_option_quantity_6" type="hidden" value="1" /> <input name="item_option_currency_6" type="hidden" value="USD" /> <input name="item_option_name_7" type="hidden" value="Corporate" /> <input name="item_option_price_7" type="hidden" value="100.0" /> <input name="item_option_description_7" type="hidden" value="Get a mention on the website" /> <input name="item_option_quantity_7" type="hidden" value="1" /> <input name="item_option_currency_7" type="hidden" value="USD" />
					</p>
				</td>
				<td align="left" width="1%">
					<input src="https://checkout.google.com/buttons/buy.gif?merchant_id=206633256322892&amp;w=121&amp;h=44&amp;style=trans&amp;variant=text&amp;loc=en_US" type="image" />
				</td>
			</tr>
		</tbody>
	</table>
</form>

<p>
	<b>NOTICE!</b> IF YOU DO NOT RECEIVE A CONFIRMATION E-MAIL FROM GOOGLE CHECKOUT, YOUR PAYMENT HAS NOT GONE THROUGH. Please try again, or send a check to the address below.
</p>

<p>
	<font size="3"><font size="2"><b>Payment by Check</b></font></font><font size="3"><b> </b></font>
</p>

<p>
	&nbsp;
</p>

<p>
	<font size="3"><font size="2">Make your check payable to Coliseum Square Association and send it and <a href="/wp-content/uploads/2013/02/membership-form_general1.pdf" target="_blank">this form</a> back to us at:</font></font>
</p>

<p>
	<font size="2">P.O. Box 50024<br />
	New Orleans, LA 70150-0024</font>
</p>

<p>
	<font size="2">Your dues are tax deductible, less the value of House Tour tickets ($20 each).</font>
</p>
