<form target="paypal" https://www.paypal.com/cgi-bin/webscr method="post">
<input type="hidden" name="cmd" value="_s-xclick">
<input type="hidden" name="hosted_button_id" value="GECKKPYPBWD4W">
<table>
<tr><td><input type="hidden" name="on0" value="Student Name">Student Name</td></tr><tr><td><input type="text" name="os0" maxlength="200"></td></tr>
<tr><td><input type="hidden" name="on1" value="Teacher">Teacher</td></tr><tr><td><input type="text" name="os1" maxlength="200"></td></tr>
</table>
<input type="image" https://www.paypalobjects.com/en_US/i/btn/btn_cart_LG.gif border="0" name="submit" alt="PayPal - The safer, easier way to pay online!">
<img alt="" border="0" https://www.paypalobjects.com/en_US/i/scr/pixel.gif width="1" height="1">
</form>