Donation Form

Other Contribution

I am donating

To honor a teacher

To help CKA reach its goals

Other reason

First Name *

Last Name *

Address *

City *

State *

ZIP code *

Phone(H) *

Phone(W) *

Personal Email *

(An e-mail address is required for online submission confirmation. CKA does not share e-mail addresses with third parties.)

Fax *

Member Number

Honoree's Title

Reason for honoring this person (if applicable)

Honoree's First Name

Honoree's Last Name

Honoree's Address

Honoree's City

Honoree's State

Honoree's ZIP code

Honoree's Phone(H)

Honoree's Personal Email

As we are transitioning to our new website, we are not yet able to accept secure payments. Please fax or mail your billing information to us. Our contact information is at the bottom of this page. We are sorry for the inconvenience.

Donation Form

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