PAX West 2019 Challenge Coin Order Form
Welcome to the order form for the PAX West 2019 Challenge Coin.  

For this form, you must 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.  

I have provided a payment chart located at https://docs.google.com/spreadsheets/d/1AsgJrenKv-KfCCSwpDIh94DCoxqwT2m2-Yj5VqQeR6U/edit?usp=sharing for your convenience.  

For more details on the pricing of the coins, please check out https://docs.google.com/document/d/15WaL2-0RsO94sB1noLb6BvDYSGjmNHq5gSWiMO5BV7g/edit?usp=sharing

Thank you for your patience.

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Once you have selected your preferred method and number of coins please send your full payment to marty@kccoin.com via PayPal. You can use this http://paypal.me/kiddercorp to pay Kiddercorp for the coins.

You must make your payment first so you can add the transaction ID here.
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Paypal ID/Email *
The PayPal account you used to pay for your coins
Paypal Transaction ID *
Payment needs to be made to marty@kccoin.com via PayPal before filling out this form.  Your transaction ID should be listed in the top right of your receipt email from PayPal.
Please enter your email address *
Your email address in case we need to contact you.
Name *
Use the name on your PayPal account.
Please enter your full shipping address (Number, Street, Town, State, & Zip Code) *
Where do you want your coins shipped?
Number of Regular Coins Purchased *
Number of Colour Coins Purchased *
Total Paid *
List the total paid in USD
What is your PAX username? (optional)
If you'd like to associate this transaction with your PA username, you can!  Otherwise leave blank.
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