EMERGENCY MEDICINE ACTION FUND

Online Contribution Form

Online contributions to the Emergency Medicine Action Fund are quick, easy and secure.
What type of contribution would you like to make?

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 –

  • Governors Circle – a minimum contribution of $100,000. Groups, coalitions and individuals contributing at this level are eligible for one of 10 open seats on the Emergency Medicine Action Fund Board of Governors.
  • Contributors Circle – for contributions between $50,000 and $100,000
  • Sustainers Circle – for contributions up to $50,000

*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.

Contribution $

Personal Information

If you have your ACEP ID, please provide it below and click "Look up" to tie this donation to your record.
Do you have an ACEP ID?
Title
First Name *
Last Name *
Attention Line
Street *
Apt/Suite
City *
Country *  
State
Zip/PostalCode *  
Email Address *  

Billing Information

Credit Card Type *
Name as appears on the Credit Card *
Credit Card Number *  
CVV Number *  What is CVV?
Expiration date *  

Feedback
Click here to
send us feedback