How Do I Join?
Please complete this AACEPAC membership form
and send it along with your contribution.
Name: ____________________________________
Phone: ____________________________________
E-mail: ___________________________________
Address: ___________________________________
_________________________________________
City: _____________________________________
State: _________________ Zip: ________________
Occupation: _______________________________
Employer: _________________________________
Method of Payment:
❏ Check
❏ Credit Card
CC Number: _______________________________
CC Expiration Date: _________________________
I would like to support AACEPAC
by contributing:
❏ $1000 (Chairman’s Circle)
❏ $500 (Gold Member)
❏ $250 (Silver Member)
❏ $100 (Bronze Member)
❏ $50 (AACEPAC Member)
❏ Other $ _____________
Mail to:
AACEPAC
245 Riverside Avenue, Suite 200
Jacksonville, Fl 32202
800-393-2223
aacepac@aace.com
Or contribute online at:
www.aace.com/advocacy/leg/aacepac
Membership Information
• Please note that the maximum annual contribution allowed by law is $5000.
• Contributions are not deductible as a charitable
contribution for federal income tax purposes.
• Please note that corporate credit cards or checks
(PA) cannot be accepted. We do accept personal
checks and personal credit cards. AACEPAC is
a Federal PAC, which supports candidates for
election to federal offices (Congress). The Federal Election Campaign Act, 2 U.S.C. 441b(a),
prohibits corporations and labor organizations
from making contributions or expenditures in
connection with federal elections. For this reason, contributions to AACEPAC must be from
a personal account.
• Upon request, copies of AACEPAC Bylaws
will be furnished and an annual statement of
your contribution will be sent to you when you
contribute to AACEPAC.
Notice: The purpose of this material is purely
descriptive and informative. Participation in the
AACEPAC program by members and employees is
strictly voluntary. All monetary figures expressed herein
are merely suggested guidelines for those who wish to
contribute to AACEPAC.
AACEPAC Mission
F
ormed i n 2 0 0 1 , the
American Association of Clinical
Endocrinologists Political Action
Committee (AACEPAC) promotes the
interests of endocrinologists and their
patients through all forms of political
action. AACEPAC contributes to congressional candidate campaigns which
share AACEPAC’s views on health
issues, and supports passage or defeat
of legislative and regulatory issues that
impact endocrinology.
AACEPAC provides an important vehicle for supporting the principles of
better health and those candidates for
elective office who share this goal. Each
election cycle brings new challenges to
the clinical endocrinologist and the
practice of medicine, and AACEPAC
support can mean the difference between victory and defeat.
How Can I Make a Difference?
By voluntarily contributing to AACEPAC,
you are joining your colleagues who share
your concerns about America’s future health
care delivery system. Combining the contributions of many practicing endocrinologists greatly enhances our ability to provide
meaningful support to candidates for the
United States Congress who will support
our common goals.
Your contribution allows AACEPAC to
support candidates who will be receptive
to our concerns and represent the interests
of our patients in legislative and regulatory decisions related to organized medicine, managed care, federal agencies, and
other health care related matters. Please
unite with your colleagues to help ensure
your future ability to provide the best care
possible for your patients and preserve the
future of your practice as part of a free enterprise system of health care.
AACEPAC Membership Categories
$1,000 - $5,000
$500 + $250 +
$100 +
$50 +
Chairman’s Circle
Gold Member
Silver Member
Bronze Member
AACEPAC Member
•
All AACE members in the United
States, their families and office
staff are eligible and invited to
make annual contributions to
AACEPAC (international members
are prohibited from contributing
under federal election laws).
•
Remember, AACEPAC is an annual contribution program so
please make sure to keep your
membership current! Your support for AACEPAC demonstrates
your strong commitment to
AACE advocacy activities.