About the GKCWPC

Your name:

Your email address:

Your phone number:

Street:

City:

State:

Zip:

Credit Card Number:

CVC Code:

Expiration Date:

Credit Card Type:

Young Friends Membership $25

Glowing Embers Membership $35

Torch Light Membership $65

Flame Keeper Membership $100

Lady Liberty Membership $250

One Time Donation

Sustaining Donation, a
small monthly donation will
be charged at the start of
each month

Jail House Door Pin $20

Irma Starr Pottery $10

Susan B Anthony Coin Necklace $25

Carnahan Book $60

Notes or Special
Instructions:

For All Payments, please fill out the form below. For questions or
refunds, email info@gkcwpc.org or treasurer@gkcwpc.org

Please select each item that you plan on purchasing

Payments will be processed via Square. Please provide an email
address for your receipt.

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