CAPA’s Political Action Committee Contributions


Thank you for supporting CAPA’s PAC. We are hoping that every PA in California will give an amount equal to one hour’s pay. However, contributions of any size are appreciated and will help us to reach our goal. Thanks again.


Contributions to CAPA’s Political Action Committee are voluntary and not tax deductible. The CAPA PAC ID number is#981553.

*All fields are required on this form!

*First Name:
*Last Name:
*PA License #:
(If you do not have a PA license, please enter 99999)
*Designation i.e., PA-C:
*Home Address:
*City:
*State:
*Zipcode:
*Occupation:
*Name of Employer:
*Work Address:
*City:
*State:
*Zipcode:
*Home Phone:
*Work Phone:
*Email Address:
*Amount: (Please enter donation amount)
 
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