<form action="avant_paypal.php" method="post" >

<tr><td>Civilité :</td><td><select name="choix" id="civilite">

<option >M</option>

<option >Mme</option>

<option >Mlle</option>

</select><br /> </td>

	<tr><td>Nom :</td> <td><input type="text" name="nom" maxlength="32"/></td> </tr>

<tr><td>Prenoms :</td> <td><input type="text" name="prenom" maxlength="32"/></td></tr>

<tr><td>Adresse :</td> <td><input type="text" name="adress" maxlength="32"/></td></tr>

<tr><td>Post Code :</td> <td><input type="text" name="post_code" maxlength="6"/></td></tr>

<tr><td>Date de Naissance :</td> <td><input type="text" name="dat_nais" maxlength="32"/></td></tr>

<tr><td>Lieu de Naissance :</td> <td><input type="text" name="lieu_nais" maxlength="32"/></td></tr>

<tr><td>Nationalité :</td> <td><input type="text" name="nationalite" maxlength="32"/></td></tr>

<tr><td>Téléphone :</td> <td><input type="text" name="phone" maxlength="32"/></td></tr>

<tr><td>Mail : <td><input type="text" name="mail" maxlength="50"/></td></tr>

<tr><td>Montant du droit d'adhésion :</td> <td><input type="text" name="montant" maxlength="50"/></td></tr>

<tr><td>Option désirée:</td><td><input type="radio" name="desiree" value="Or"/>Or <input type="radio" name="desiree" value="argent"/>Argent  <input type="radio" name="desiree" value="Platinium"/>Platinium </td></tr>

<tr><td>Pays :</td> <td><input type="text" name="pays" maxlength="32"/> </td></tr>

<tr><td>Ville :</td> <td><input type="text" name="ville" maxlength="32"/></td></tr>

<tr><td><input type="submit" name="valider" value="Enregistrer" /> </td>

  <td><input name="reset" type="reset" value="Annuler" /></td>

</tr>

<?php



$choix= $_POST['choix'];

$nom = $_POST['nom'];

$prenom  = $_POST['prenom'];

$adress = $_POST['adress'];

$dat_nais = $_POST['dat_nais'];

$lieu_nais = $_POST['lieu_nais'];

$nationalite =$_POST['nationalite'];

$phone = $_POST['phone'];

$mail = $_POST['mail'];

$montant = $_POST['montant'];

$$optiond = $_POST['desiree'];

$pays = $_POST['pays'];

$ville = $_POST['ville'];



echo'Vos données entrées : '.'<br/><p></p>';

if(isset($_POST['valider'])){

foreach($_POST as $index=>$valeur){

if ($index!='valider'){

echo '- '.$index.' : '.$valeur.'<br/>';

}

}

}

 echo '<form action="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="xxxxxxxx">

<table>

<tr><td><input type="hidden" name="on0" value=""></td></tr><tr><td>

<select name="os0">

	<option value="Argent">Argent : £10.00GBP - monthly</option>

	<option value="Or">Or : £15.00GBP - monthly</option>

	<option value="Platinium">Platinium : £20.00GBP - monthly</option>

</select> </td></tr>

</table>

<input type="hidden" name="currency_code" value="GBP">

<input type="image" src="https://www.paypal.com/fr_FR/FR/i/btn/btn_subscribe_LG.gif" border="0" name="submit" alt="PayPal - la solution de paiement en ligne la plus simple et la plus sécurisée !">

<img alt="" border="0" src="https://www.paypal.com/en_GB/i/scr/pixel.gif" width="1" height="1">

</form>





  <input name="reset" type="reset" value="Annuler Votre Souscription" /></td>

</tr> </table>'; 

?>

<tr><td>Option désirée:</td><td><input type="radio" name="os0" value="Argent"/>Argent <input type="radio" name="os0" value="Or"/>Or  <input type="radio" name="os0" value="Platinium"/>Platinium </td></tr>

$os0 = $_POST['os0'];



<select name="os0" >

 <option value="Argent" <?php if($_POST['os0']=="Argent") echo "selected"; ?>>Argent : £10.00GBP - monthly</option>

 <option value="Or" <?php if($_POST['os0']=="Or") echo "selected"; ?>>Or : £15.00GBP - monthly</option>

 <option value="Platinium" <?php if($_POST['os0']=="Platinium") echo "selected"; ?>>Platinium : £20.00GBP - monthly</option>

</select>