PAX South 2020 Challenge Coin Order Form

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Welcome to the order form for the PAX South 2020 Challenge Coin.
Please fill out this form in its entirety AFTER you have submitted a PayPal payment to Kiddercorp (their account is marty@kccoin.com).
This is required in order to fill out the PayPal Transaction ID question.

To calculate your total, you can use this form: http://bit.ly/PAXCoinCalc

Unpainted coins: $7 ea
Painted coins: $8 ea

Then add
US Shipping:
1-3 coins: $3
4-6 coins: $4
7+ coins: $7

International Shipping:
1-6 coins: $15
7+ coins: $31

Some of this may seem redundant after Paypal, but we want to ensure we have the correct information before shipping. The first batch of coins consists of 100 painted and 100 unpainted. We will accept orders beyond that, however, they may not arrive in time for PAX South 2020. You can keep an eye on the forum (https://forums.penny-arcade.com/discussion/231296/pax-south-2020-challenge-coin-its-happening#latest) as I will try to notify when we're close, and once we have crossed into the second batch order.

Email *

PayPal ID/Email *

PayPal Transaction ID *

First Name *

Last Name *

Address 1 *

Address 2

City *

State *

Zip *

Country *

Number of Regular Coins Ordered *

Number of Painted Coins Ordered *

Total Paid (in USD) *

Would you like to be notified next year when the design process is started and contribute? If so, please leave your forum name, e-mail, or Facebook profile link here:

Send me a copy of my responses.

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