PAALS PACK SUBSCRIPTION
Contact Information
First Name
Last Name
Email
Phone
Billing Information
Street Address (Line 1)
Street Address (Line 2)
City
State
Please select...
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Puerto Rico
Virgin Island
Northern Mariana Islands
Guam
American Samoa
Palau
Zip
PAALS PACK SUBSCRIPTION OPTIONS
How would you like to pay for your support subscription?
Yearly
Bi-Annually
Quarterly
Monthly
Please select your YEARLY donation
$150
Yearly
OR
$154.79 - I will cover PAALS banking fees
$300
Yearly
OR
$309.27 - I will cover PAALS banking fees
$600
Yearly
OR
$618.23 - I will cover PAALS banking fees
$900
Yearly
OR
$927.19 - I will cover PAALS banking fees
$1,200
Yearly
OR
$1,236.15 - I will cover PAALS banking fees
Please select your BI-ANNUAL donation.
$75 (2x year) OR
$77. 55 - I will cover PAALS banking fees
$150 (2x year) OR
$154.79 - I will cover PAALS banking fees
$300 (2x year) OR
$309.27 - I will cover PAALS banking fees
$450 (2x year) OR
$463.75 - I will cover PAALS banking fees
$600 (2x year) OR
$618.23 - I will cover PAALS banking fees
Please select your QUARTERLY donation.
$37.50 (4x year)
OR
$38.93 - I will cover PAALS banking fees
$75 (4x year) OR
$77.55 - I will cover PAALS banking fees
$150 (4x year) OR
$154.79 - I will cover PAALS banking fees
$225 (4x year) OR
$232.03 - I will cover PAALS banking fees
$300 (4x year) OR
$309.27 - I will cover PAALS banking fees
Please select your MONTHLY donation.
$12.50
monthly OR
$13.18 - I will cover PAALS banking fees
$25
monthly
OR
$26.06 - I will cover PAALS banking fees
$50
monthly
OR
$51.80 - I will cover PAALS banking fees
$75
monthly
OR
$77.55 - I will cover PAALS banking fees
$100
monthly
OR
$103.30 - I will cover PAALS banking fees
How would you like to pay for the recurring payments
Bank Account
Credit Card
Payment Information
Name on Account
Bank Name
Bank Routing Number
Bank Account Number
Account Type
Checking
Savings
Payment Information
Type of Credit Card
MasterCard / Visa
American Express
Other
Full Name on Card
Credit Card Number
MM
YY
CVV
CVV
CVV Code for Connector
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