+<form method="get" action="https://secure.fdn2.org/fdn2/nouser">
+  <div>
+    <div>
+      <input type="radio" name="px" id="amount-10" value="10"
+      /><label for="amount-10">10 €</label>
+    </div>
+    <div>
+      <input type="radio" name="px" id="amount-25" value="25"
+      /><label for="amount-25">25 €</label>
+    </div>
+    <div>
+      <input type="radio" name="px" id="amount-50" value="50"
+      /><label for="amount-50">50 €</label>
+    </div>
+    <div>
+      <input type="radio" name="px" id="amount-100" value="100"
+      /><label for="amount-100">100 €</label>
+    </div>
+    <div>
+      <input type="radio" name="px" id="amount-250" value="250"
+      /><label for="amount-250">250 €</label>
+    </div>
+    <div>
+      <input type="radio" name="amount" id="amount-custom" value=""
+      /><label for="amount-custom">Autre</label><!-- XXX: need some support code,
+      <label for="custom-amount">montant :</label
+      > <input type="text" name="custom-amount" id="custom-amount" />
+      -->
+    </div>
+  </div>
+  <!-- XXX: need some support code
+  <div>
+    <input type="checkbox" name="recurring" id="reccuring" value="true" />
+    <label for="recurring">Je souhaite faire ce don tous les mois
+    (<em>banque française seulement</em>).</label>
+  </div>
+  -->
+  <div>
+    <input type="hidden" name="lang" value="fr" />
+    <input type="hidden" name="dest" value="oignon" />
+    <input type="submit" name="submit" id="submit" value="Soutenez le réseau Tor…" />
+  </div>
+</form>
+