Online Contribution Form
Online contributions to the Emergency Medicine Action Fund are quick, easy and secure.
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What type of contribution would you like to make?
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The Emergency Medicine Action Fund accepts contributions of all sizes from anyone
interested in supporting the efforts to impact the federal regulatory process and
advance emergency medicine. Individuals, chapters, sections and others are encouraged
to combine their resources to form a coalition that could be eligible to have representation
on the Action Fund’s Board of Governors. Funding levels are –
- Groups, eligible organizations and coalitions - $75,000
- Emergency medicine organizations - $20,000
*While tax deductibility can only be determined by donors’ tax advisors, the intent
of the Emergency Medicine Action Fund is to use donor funds for items typically
deductible as business expenses.
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Contribution
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* Please enter a valid contribution amount
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Personal Information
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If you have your ACEP ID, please provide it below and click "Look up" to tie this donation to your record.
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Do you have an ACEP ID?
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Title
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First Name *
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Last Name *
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Attention Line
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Street *
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Apt/Suite
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City *
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Country *
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State
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Zip/PostalCode *
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Email Address *
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* Please enter a valid e-mail address
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Billing Information
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Credit Card Type *
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Name as appears on the Credit Card *
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Credit Card Number *
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CVV Number *
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What is CVV?
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Expiration date *
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