KPAC Contributions

Upon completing this form, hit submit and you will be directed to the KNEA PayPal site to complete your donation.
Full name and address are required by law.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
The following information is NOT REQUIRED, but will help us to better track your contribution. We will not use your contact information for any purpose beyond KPAC record keeping.
Phone Number

Area CodePhone Number
E-mail
What is your UniServ?
Work Location?
Donation Amount (USD Stands for US Dollars)

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USDKPAC Donation
Should be Empty:

Upon completing this form, hit submit and you will be directed to the KNEA PayPal site to complete your donation.