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Contribution Pledge Form
*
First Name
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Last Name
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Phone Number
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Email Address
*
Mailing Address
Thank you for your contribution. AzPA appreciates your generosity and support.
Please
click here
to view contribution level descriptions and benefits.
*
Which level of contribution would you like to make?
Please visit this link to view contribution level descriptions and benefits: https://azpa.org/support
Grand Canyon - $1,000 and up
Saguaro - $500-$999
Red Rock - $250-$499 (monthly option available)
Sonoran - $100-$249
Copper - less than $100
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How would you like to be billed?
A one (1) time payment of the full amount.
Monthly payments (only available for contributions over $250)
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What is your preferred payment method?
If you wish to pay by credit card, you will be prompted to do so on the following page. If you wish to pay by check, please mail checks to: AzPA, 107 S. Southgate Dr., Chandler, AZ 85226.
Check
Credit Card
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Where would you like to direct your contribution?
The AzPA General Fund supports member activities, community outreach, helps to offset costs of continuing education offerings, etc.
AzPA General Fund
Legislative Contribution Fund
Diversity Committee
RxP Legislative Efforts (#MentalHealthNowAZ)
Wherever funds are needed the most.
