Thank you for your generous support!
* Required Fields
Personal Information








 
Sign me up for email updates.
Employment Information


To comply with law, contributors are required to provide their employment information. If you are retired, please enter N/A under Employer and Retired under Occupation; if a homemaker, please enter N/A - Homemaker; if self-employed, please enter "Self-Employed" under Employer and describe your line of work under Occupation.
Contribution Information


Month Year

Payment Information

VisaMasterCardAmerican Express

What's this?
Confirm Eligibility
* I confirm that the following statements are true and accurate:

  • I am not a foreign national who lacks permanent residence in the United States.

  • This contribution is made from my own funds, and not those of another.

  • This contribution is not made from the funds of a corporation or labor organization.

  • I am at least eighteen years old.

  • I am a current member of the American Pharmacists Association.
Contributions or gifts to American Pharmacists Association Political Action Committee are not tax deductible.
Federal law requires us to use our best efforts to collect and report the name, address, occupation and name of employer of individuals whose contributions exceed $200 per year. Contributions are limited to $5000 annually.

powered by CQ Roll Call © 2017