Template:2011FR/Form-section-radiobuttons-2

{{2011FR/Form-section-radiobuttons-2/{{{country}}}

              | country = {{{country}}}
              | uselang = {{{uselang}}}
              | currency-position = before
              | currency-symbol = $
              | donate-amount-0 = 5
              | donate-amount-1 = 10
              | donate-amount-2 = 20
              | donate-amount-3 = 35
              | donate-amount-4 = 50
              | donate-amount-5 = 100
              | donate-amount-6 = 250
            }}