document.write('<a name="Payment"></a><FORM ACTION="https://w3safesecure.com/W3ShoppingCart/cart/cart.cfm" METHOD="POST" class="CuteKart_Product_Form" TARGET="foobar:width={window.screen.width/2}, height={myHeight}, width={myWidth}, scrollbars=1, menu=0, location=0, toolbar=1, resizable=1, status=1"  onSubmit="return sForm(this);"><table border="0" cellpadding="3" cellspacing="0"><tr><TD valign="top" class="CuteKart_Product_Info_Area_Background"><DIV class="CuteKart_ProductName">Make a Payment</DIV><DIV class="CuteKart_Description_Text"></DIV><DIV class="CuteKart_Selection_Block"><DIV class="CuteKart_Option_Block"><DIV class="CuteKart_Option_Text"><LABEL ID="l1756" FOR="T_1756_49_0">Student Name:</LABEL></DIV> <input ID="T_1756_49_0" type="text" name="Selection_1756_1" size="25" maxlength="255"></DIV><DIV class="CuteKart_Option_Block"><DIV class="CuteKart_Option_Text"><LABEL ID="l1757" FOR="T_1757_49_0">Invoice Number:</LABEL></DIV> <input ID="T_1757_49_0" type="text" name="Selection_1757_2" size="25" maxlength="255"></DIV><DIV class="CuteKart_Option_Block"><DIV class="CuteKart_Option_Text">*<LABEL ID="l1758" FOR="T_1758_48_1">Reason for Payment:</LABEL></DIV> <textarea ID="T_1758_48_1" name="Selection_1758_3" rows="6" cols="45"></textarea></DIV></DIV><DIV class="CuteKart_Price_Text">&nbsp;<strong>*<LABEL ID="lPriceEach" FOR="T_PriceEach_14_1">Enter Amount&nbsp;$</LABEL></strong><input  ID="T_PriceEach_14_1" type="text" name="PriceEach" style="width:55px; font-size:12px;font-family:arial,helvetica" value="">&nbsp;&nbsp;</DIV><DIV><input type="submit" value="Pay Now" class="CuteKart_Add_to_Cart_Button_Text" title="Pay Now - Make A Payment Category - Make a Payment" name="submitbutton"></DIV></TD></tr></table><INPUT TYPE="hidden" NAME="action" VALUE="add"><INPUT TYPE="hidden" NAME="ItemNumber" value="Payment"><INPUT TYPE="hidden" NAME="Admit" VALUE="2238754"><INPUT TYPE="hidden" NAME="RecurringPeriod" VALUE=""><input type="hidden" name="wspk_1_PriceEach" value="0.01"><input type="hidden" name="wspk_2_PriceEach" value="99999"><input type="hidden" name="wspk_1_1758" value="1"><input type="hidden" name="l72844" value="119245597"><input type="hidden" name="formID" value="1637"><input type ="hidden" name="wtitle_PriceEach" value="Enter Amount"><input type ="hidden" name="wtitle_Selection_1756_1" value="Student Name"><input type ="hidden" name="wtitle_Selection_1757_2" value="Invoice Number"><input type ="hidden" name="wtitle_Selection_1758_3" value="Reason for Payment"></FORM><noscript><DIV align="left" style="text-align:left;margin:0px"><DIV style="width:140px;text-align:center;white-space:nowrap" align="center" width="140"><a href="http://W3ShoppingCart.com" target="_blank"><img src="http://W3ShoppingCart.com/images/tinyLogo.gif" border="0" alt="W3 Shopping Cart eCommerce Shopping Cart"></a><br><a href="http://W3ShoppingCart.com" style="font-size:9px;color:#808080;font-family:arial,helvetica" target="_blank"><b>eCommerce Shopping Cart</b></a></DIV></DIV></noscript>');
