Contribute to HOSPAC

YES! I want to help Alabama’s hospitals and health systems strengthen their voices in the Alabama Statehouse and in Washington, D.C. Please click here to download a brochure with information about HOSPAC and a form with instructions to contribute. To make an online contribution, complete the information below.

For more information, please contact Danne Howard at the AlaHA Government Relations Office at (334) 834-3477.

*Please remember to enter your hospital affiliation below

Yes, I want to make the hospital voice heard!

"*" indicates required fields

I want to contribute:*

Please specify other amount:

Date*

Please use my contribution for the state PAC only.

Name*

First Last

Home Address*

Street Address City State ZIP Code

Email*

Hospital Affiliation:*

Occupation/Title:*

Paying by check:

If paying by check, make your check payable to HOSPAC and mail payment, along with the printed confirmation page (available after you click “Submit” below), to the Alabama Hospital Association Government Relations Office, Suite 290, 770 Washington Ave., Montgomery, Ala. 36104.

Paying by PayPal:

You can also contribute online using PayPal, with either a one-time donation or recurring monthly payments. Once you click “Submit,” you will see a confirmation page. To access PayPal, scroll to the bottom of the confirmation page and then click “Donate.” Once you click “Donate” you will be able to complete the payment process.

Phone

This field is for validation purposes and should be left unchanged.