Arizona Area Contribution Form "*" indicates required fields Contribute from:*Please select one...GroupDistrictInformation ServiceIndividual7th Tradition AWSC7th Tradition Assembly7th Tradition Delegates DayAWSC Contribution Amount Delegates Day Contribution Amount Assembly Contribution Amount Group Contribution Amount (Number: | Name: ) WSO Group NunberGroup NameDistrict Contribution Amount (Number: ) District NumberInformation Service Contribution Amount (Name: ) Information Service NameIndividual Contribution Amount Would you like this to be an automatic monthly reoccurring contribution?*YesNoYou must select PayPal checkout if yes.Total Reoccurring Monthly Total Name* First Last Email* Billing Address* Street Address Address Line 2 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 Payment Method*Credit CardPayPal Checkout American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Security Code Cardholder Name CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Δ
