<h3 class="payment-title">Step 1 of 2</h3><!-- [et_pb_line_break_holder] --><h2 class="payment-subtitle">Please fill out the information below</h2>

<form<!-- [et_pb_line_break_holder] --> action="https://checkout.globalgatewaye4.firstdata.com/pay"<!-- [et_pb_line_break_holder] --> id="pay_now_form_f8a9405ccd"<!-- [et_pb_line_break_holder] --> method="post"<!-- [et_pb_line_break_holder] --> ><!-- [et_pb_line_break_holder] --> <input type="hidden" name="x_login" value="WSP-UNIVE-7BxBhwDOHw" /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="x_show_form"<!-- [et_pb_line_break_holder] --> value="PAYMENT_FORM"<!-- [et_pb_line_break_holder] --> /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="x_fp_sequence"<!-- [et_pb_line_break_holder] --> value="15905006263316257523"<!-- [et_pb_line_break_holder] --> /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="x_fp_hash"<!-- [et_pb_line_break_holder] --> value="PNB-1.0-d27a60bc07f71417015f4b7533b5812d19ae14ba"<!-- [et_pb_line_break_holder] --> /><input type="hidden" name="x_amount" /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="x_currency_code"<!-- [et_pb_line_break_holder] --> value="USD"<!-- [et_pb_line_break_holder] --> /><input type="hidden" name="x_test_request" value="FALSE" /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="x_relay_response"<!-- [et_pb_line_break_holder] --> value=""<!-- [et_pb_line_break_holder] --> /><input type="hidden" name="donation_prompt" /><input<!-- [et_pb_line_break_holder] --> type="hidden"<!-- [et_pb_line_break_holder] --> name="button_code"<!-- [et_pb_line_break_holder] --> value="Pay Now Hidden Valley Community HUB"<!-- [et_pb_line_break_holder] --> /><!-- [et_pb_line_break_holder] --> </form><!-- [et_pb_line_break_holder] -->