AAP/PLAN Contribution Form

You can make your contribution to AAP/PLAN by credit card or check.

To contribute using your credit card, click here.

To contribute using a check: Complete and then print this page and mail it with your check to AAP  • P.O. Box 38129 • Colorado Springs, Colorado 80937

Name
Address
City
State	Zip
Email
	Federal law requires us to use our best efforts to collect and report the name, mailing address, occupation, and employer for individuals whose contributions exceed $200 in a calendar year.  To help comply with this law, please provide the following:
Employer
Occupation
Support Level and Designation	A contribution now of $ A monthly contribution of $ A quarterly contribution of $
	Please use my contribution to promote The Practice Agenda The Education Agenda The Science Agenda
Payment	Please send check with your mailed application
Please sign:	________________________________
To comply with Federal Election Commission requirements, we must confirm that the following statements are true for all on-line contributors.  Please check the box before each statement that applies to you.  Your contribution can not be accepted unless each box is checked.	This contribution is made from my own funds and not from those of another. This contribution is not made from the general treasury funds of a corporation, labor organization, or national bank. I am not a federal government contractor, nor am I a foreign national who lacks permanent resident status in the United States. This contribution is made with a personal check or on a personal credit card for which I have the legal obligation to pay, and is not made either on a corporate or business entity check or credit card or on the card of another person.
	NOTE: Contributions to AAP/PLAN are NOT deductible for federal income tax purposes.