Donation Form
American College of Physicians (ACP) is a 501(c)(3) organization and is an agent of the Arizona Chapter of the ACP, which is also a 501(c)(3) organization. Charitable donations are 100% tax deductible. Contact info@acpazchapter.org for further info. Thank you for contributing to the Arizona chapter!
Name
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First Name
Last Name
Email
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example@example.com
If you would like to direct your funds, please indicate that here. If no option is chosen, funds will be used at the discretion of the board.
Discretionary chapter support
Sponsor a medical student to attend the annual meeting
Sponsor a resident/fellow to attend the annual meeting
Support a student or resident/fellow to participate in an ACP National event
Support a Great Debates program
Other
If you would like to contribute a different or larger amount than listed below, or prefer to donate via check, please check the box below. We will reach out to communicate directly and send an invoice.
Please contact me.
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$25 Donation
Bronze Level donation
$25.00
$
25.00
$50 Donation
Bronze Level donation
$50.00
$
50.00
$100 Donation
Bronze Level donation
$100.00
$
100.00
$250 Donation
Silver Level donation
$250.00
$
250.00
$500 Donation
Gold Level donation
$500.00
$
500.00
$1000 Donation
Platinum Level donation
$1,000.00
$
1,000.00
Debit or Credit Card
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