Form Test - Kansas Honor Banners

I would like to:

Complete a banner order by providing a photo and payment.
Make a donation to sponsor the production of Kansas Honor Banners.
Make a general inquiry.

Name of Applicant:*

First Last

Applicant Email Address:*

Applicant Phone Number:*

Subject's Name:*

First Middle Last Suffix

Subject's Military Branch

Rank (if known) or description:

Examples: Private 1st Class, Corporal 101st Airborne, Fighter Pilot/POW

Years of Service (if known):

Examples: 1942-1945, 2018-Present, 10 Years of Service

Please upload your files:

Drop files here or

Max. file size: 256 MB.

Preferred Display Location:

Old Town District
Historic Delano District
Nomar International District

Contact Name:*

First Last

Contact Email Address:*

Contact Phone Number:*

Company:

Donation Amount*

All payments will be submitted to Veterans Unidos, a 501c(3) non-profit organization. All contributions are tax-deductible. All payments will be made via PayPal.

Price (click submit below to complete your payment securely on PayPal)*

$150 - 1 Season
$225 - 2 Seasons
$300 - 3 Seasons

All payments will be submitted to Veterans Unidos, a 501c(3) non-profit organization. All contributions are tax-deductible. All payments will be made via PayPal.

Name:*

First Last

Email Address:*

Phone Number:*

Message:

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