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Select either Form: Single Subscription (left) or Multiple Subscription (rt)
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Single Subscription ORDER FORM
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Your name
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First
Last
Email (confidential)
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Phone Number (confidential)
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Choose One
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I'm ordering a 1-year subscription
I'm ordering a 2-year subscription
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Recipient's name
*
First
Last
Address
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Line 1
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City
State
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Country
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CONTRIBUTION
$20-40 sliding scale -
for a 1-year subscription
$35-80 sliding scale -
for a 2-year subscription
Amount
*
$
Payment Options
*
Paypal/credit card
I will send a check
You don't need a Paypal account to pay with a credit card via Paypal.
Is this a gift subscription?
*
no
yes
Email for gift subscription recipient
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Gift Note
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____________________________________________
How did you hear about us?
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website/search engine
Positive News in print
someone referred me
your fundraising appeal
other
Note to us
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Submit
Multiple Subscriptions ORDER FORM
When ordering 3 subscriptions, the 4th one is fre
e.
*
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Your name
*
First
Last
Your email (confidential)
*
Phone Number (confidential)
*
__________________________________
#1
Recipient's name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Recipient's email
*
Gift Note
*
__________________________________
#2
Recipient's name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Recipient's email
*
Gift Note
*
__________________________________
#3
Recipient's name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Recipient's email
*
Gift Note
*
__________________________________
#4
(free subscription)
Recipient's name
*
First
Last
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Recipient's email
*
Gift Note
*
___________________________________________
How many subscriptions total?
*
__________________________________________
CONTRIBUTION - sliding scale
2 Subscriptions: $40-80
3 Subscriptions: $60-100
4 Subscriptions: $60-100
Amount
*
$
Payment Options
*
Paypal/credit card
I will pay by check
You don't need a Paypal account to pay with a credit card via Paypal.
____________________________________________
How did you hear about us?
*
website/search engine
Positive News in print
digital Positive News
someone suggested it
your fundraising appeal
other
Note to us
*
Submit
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