PAX East 2020 Challenge Coin Order Form!
Welcome to the order form for the PAX East 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
All prices are in USD.

Unpainted coins: $7 each.
Painted coins: $8 each.

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.
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Email address *
Color Coin
Regular Coin
PayPal ID/Email *
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 top right of your receipt email from PayPal.
Name *
Full Shipping Address *
Number of Regular Coins purchased. *
Number of Colored Coins purchased. *
Total Paid. *
List the total you paid in USD.
Bonus Question! What is your Penny Arcade forum name?
If you'd like to associate this transaction with your PA username, you can! Otherwise leave blank.
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