Alabama Academy of Eye Physicians and Surgeons

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Donation

* Mandatory fields

*First name

Middle Name or Initial

*Last name

Degree(s)

*Primary Email

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Secondary Email

Phone

Please enter a telephone number that the ALAO may use to contact you regarding Academy business. A patient phone number may be entered in that section.

Address

City

State

Zip

*Donate to:

ALAO Political Action Committee

ALAO Surgical Scope Defense Fund

Political Action Committee (PAC) contributions are reportable to the Alabama Secretary of State.

Surgical Scope Defense Fund contributions are not reportable and are not used for political contributions.

*Payment frequency

One-time

Monthly

Quarterly

Semi-annually

Annually

*Amount ($USD)

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