Calendar Order Form
PKD Calendar Order Form
Mail donations to the address above, but DON NOT COMPLETE OR SUBMIT THE FORM BELOW, since calendars are SOLD OUT. All donations go to the PKD Foundation and help fund research to find a cure for Polycystic Kidney Disease.
1. Fill out the order form and press Submit
2. Please mail a check with your total amount to the following address:
Checks payable to: "PKD Foundation - Seattle Chapter"
Address:
PKD Foundation
c/o ABFS
500 - 108th Ave. NE, Suite 910
Bellevue, WA 98004
Your order will be processed and your calendar(s) will be sent to you as soon as possible (when the next batch of calendars is printed).
Mail donations to the address above, but DON NOT COMPLETE OR SUBMIT THE FORM BELOW, since calendars are SOLD OUT. All donations go to the PKD Foundation and help fund research to find a cure for Polycystic Kidney Disease.
1. Fill out the order form and press Submit
2. Please mail a check with your total amount to the following address:
Checks payable to: "PKD Foundation - Seattle Chapter"
Address:
PKD Foundation
c/o ABFS
500 - 108th Ave. NE, Suite 910
Bellevue, WA 98004
Your order will be processed and your calendar(s) will be sent to you as soon as possible (when the next batch of calendars is printed).
Customer Information First Name: Last Name: Address: City: State: AlaskaAlabamaArkansasArizonaCaliforniaColoradoConnecticutD.C.DelawareFloridaGeorgiaHawaiiIowaIdahoIllinoisIndianaKansasKentuckyLouisianaMassachusettsMarylandMaineMichiganMinnesotaMissouriMississippiMontanaNorth CarolinaNorth DakotaNebraskaNew HampshireNew JerseyNew MexicoNevadaNew YorkOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaVermontWashingtonWisconsinWest VirginiaWyoming Zip Code: Country: E-Mail Address: Phone Number:
Items Item Price Quantity Total Cost $
Optional additional tax-deductible donation : $
Sub Total : $ Shipping and Handling ($ 3.00 per item) : $ Grand Total : $
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