Charity donation Thank you very much for showing your generosity and appreciation. We greatly appreciate your help and support! CHARITY DONATION FORM Donation Name* First Last Email* Phone*Address* Street Address City State AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Charity Donation Silver $100.00 Gold $200.00 Diamond $300.00 Charity Donation Total $0.00 When you click 'SUBMIT' you will be taken to PayPal page for completing the payment. You may sign in to your PayPal account(if you have one) or use the option "Credit/Debit Card Payment". When you complete the payment, PayPal will send you a payment confirmation email. AZINA will also send an email. Please save both emails for your records.