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Campaign Form | Aahpm.org

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Multi-Year Pledge
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AAHPM deeply appreciates your generous pledge of support for our initiatives. Please fill out the form below. Thank you for your support!
 
First Name *
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Last Name *
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Address *
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City *
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State *
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Zip *
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Phone *
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E-mail *
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Pledge Amount *     Over    years (up to 5)
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You will receive an acknowledgment email upon the completion of this form. You will also receive a statement of your pledge status in January for personal tax recording and IRS purposes.
 
The balance of this pledge will be paid: *


 
Special Requests
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Recognition
Please indicate how you would prefer your name(s) to be listed for donor recognition purposes: *
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Gift Designation
Please indicate your pledge intentions below.

I wish to designate my AAHPM campaign pledge to one of the following areas:
 



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