Annual Meeting Registration

logobanner

MOA PAC Contribution Form
YES! I DO CARE ABOUT THE FUTURE OF ORTHOPEDIC MEDICINE IN MASSACHUSETTS AND WANT TO SUPPORT POLITICAL CANDIDATES THAT ARE KNOWLEDGEABLE AND SUPPORTIVE OF THE ISSUES FACING ORTHOPEDIC PHYSICIANS.
Full Name(*)
Invalid Input
Email(*)
Invalid Input
Home Address(*)
Invalid Input
City(*)
Invalid Input
Zip(*)
Invalid Input
Employer(*)
Invalid Input
Contribution Amount
Invalid Input
(*)
Invalid Input
To pay using personal check Checks Payable to; “Mass. Orthopaedic Association PAC” Mail to MOA, 14 Robin Road, Sharon, MA 02067
** State law allows any individual to personally contribute up to an aggregate of $500 to a particular PAC in any calendar year. Please, no corporate checks. Contributions to the Mass. Orthopaedic Association PAC are not deductible for state or federal income tax purposes.

Massachusetts Orthopaedic Association, Inc. • 860-690-1146 • This email address is being protected from spambots. You need JavaScript enabled to view it.