Ohio Podiatric Political Action Committee - Donation Form



Ohio Podiatric Political Action Committee - Donation Information
Please choose a personal donation from the drop-down menu and select or enter the amount that you would like to donate to OPPAC (personal credit cards only). Important tax information: OPPAC contributions may not be deducted as business or personal deductions for income tax purposes.

Personal Donation Amount
Other Amount	$

Contact Information
First Name
Last Name
Practice Name
Address

City	State Zip
Email
Phone

- denotes required fields