Gift Card Request Note: Allow 2 business days for processingGift Card RequestDate requested(Required) MM slash DD slash YYYY VAREP Chapter(Required) Name of Person Submitting Request(Required) Email of Person Submitting(Required) Phone of Person Submitting(Required)Date Cards Needed(Required) MM slash DD slash YYYY Ship to Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Quantity and currency amount of each card(Required)(they might not order all cards in the same currency amount – there may be multiple currency and multiple cards of each)
