PAC Donations

Your AP-PAC contribution helps us support pharmacy friendly state legislators. Although your contribution directly to state legislators must be a personal contribution, you can make an AP-PAC contribution from a business account up to the $10,000 maximum annual contribution. You can take a $100 tax credit if you file a joint return ($50 for single) on your Arkansas state income taxes. Check with your accountant for details.

PAC Donations

Personal Information

Edit

First Name

Last Name

Have a login? Login Now

Username

Password

Logged in as {{Environment.CurrentUserData.DisplayName}}

Log Out

Contributing as

Continue

Amount Details

Edit

Item	Amount	Frequency	Start Date	End Date	Total
{{itemPledgeItems.Description}} (Minimum Amount: {{itemPledgeItems.ExtraOptions.MinimumPrice \| currency}})	Amount The minimum amount is {{itemPledgeItems.ExtraOptions.MinimumPrice \| currency}} The maximum amount is {{itemPledgeItems.ExtraOptions.MaximumPrice \| currency}}	Frequency	Start Date	End Date The max end date is {{formattedMaxEndDate(itemPledgeItems)}}.	Total
						Total Amount Today

Continue

Additional Information

Edit

Recognition Name

Tribute/On Behalf Of

Contribute on behalf of {{ Environment.OrgTerm }}

Message

{{cfv.DisplayName}} {{[1, 2].indexOf(cfv.CustomFieldDataTypeId) >= 0 && cfv.DataSize > 0 ? (" (Max length: " + cfv.DataSize + ")") : ""}}

Continue

Contact Information

Edit

Address

Address 2

City

State/Province

Postal Code

Country

Phone Number

Continue

Payment

Edit

We're sorry. This action requires authentication. Please log into your account and try again.

Cover processing fees

Help your contribution go further by covering the cost of processing. By checking this box, you will help ensure that 100% of your contribution goes directly to support our cause.

Payment Amount

Pay by Invoice

Please ensure all fields on the form are filled out correctly

Send Confirmation Email