Charity donation Thank you very much for showing your generosity and appreciation. We greatly appreciate your help and support! CHARITY DONATION FORM Name* First Last Email* Phone*Address* Street Address City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest 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.