<form name="pay_with_globepay" id="pay_with_globepay" action="http://www.globepayinc.com/make_payment.php" target="_blank" method="post">
<input type="hidden" name="button_type" id="button_type" value="pay_with_globepay" />
<input type="hidden" name="customer_details" id="customer_details" value="" />
<input type="hidden" name="item_name_1" id="item_name_1" value="" />
<input type="hidden" name="item_id_1" id="item_id_1" value="" />
<input type="hidden" name="price_1" id="price_1" value="" />
<input type="hidden" name="quantity_1" id="quantity_1" value="" />
<input type="hidden" name="postage_1" id="postage_1" value="" />
<input type="hidden" name="tax_rate_1" id="tax_rate_1" value="" />
<input type="hidden" name="item_name_2" id="item_name_2" value="" />
<input type="hidden" name="item_id_2" id="item_id_2" value="" />
<input type="hidden" name="price_2" id="price_2" value="" />
<input type="hidden" name="quantity_2" id="quantity_2" value="" />
<input type="hidden" name="postage_2" id="postage_2" value="" />
<input type="hidden" name="tax_rate_2" id="tax_rate_2" value="" />
<input type="hidden" name="item_name_3" id="item_name_3" value="" />
<input type="hidden" name="item_id_3" id="item_id_3" value="" />
<input type="hidden" name="price_3" id="price_3" value="" />
<input type="hidden" name="quantity_3" id="quantity_3" value="" />
<input type="hidden" name="postage_3" id="postage_3" value="" />
<input type="hidden" name="tax_rate_3" id="tax_rate_3" value="" />
<input type="hidden" name="item_name_4" id="item_name_4" value="" />
<input type="hidden" name="item_id_4" id="item_id_4" value="" />
<input type="hidden" name="price_4" id="price_4" value="" />
<input type="hidden" name="quantity_4" id="quantity_4" value="" />
<input type="hidden" name="postage_4" id="postage_4" value="" />
<input type="hidden" name="tax_rate_4" id="tax_rate_4" value="" />
<input type="hidden" name="item_name_5" id="item_name_5" value="" />
<input type="hidden" name="item_id_5" id="item_id_5" value="" />
<input type="hidden" name="price_5" id="price_5" value="" />
<input type="hidden" name="quantity_5" id="quantity_5" value="" />
<input type="hidden" name="postage_5" id="postage_5" value="" />
<input type="hidden" name="tax_rate_5" id="tax_rate_5" value="" />
<input type="hidden" name="currency" id="currency" value="USD" />
<input type="hidden" name="email_address" id="email_address" value="[email protected]" />
<a href="#" ><img src="http://www.globepayinc.com/images/pay_with_globepay.PNG" style="border:2px solid #020" onClick="
.getElementById('pay_with_globepay').submit();" style="border:none" /></a>
</form>