2024 Annual Giving Campaign Donor Form A contribution to the Educational Foundation is the most crucial investment you can make in our students and the podiatric medical profession. We invite you to make a taxdeductible contribution today and be recognized as a 2024 donor. Donations can also be made online at www.apma.org/donate. Donor Name(s)_____________________________________________________ Yes! I will donate to the APMA Educational Foundation 2024 Annual Giving Campaign: ❏ $1,000 ❏ $500 ❏ $250 ❏ $100 ❏ Other $__________ I want this to be a recurring monthly donation (circle one): YES/NO (Transactions for monthly donations are processed during the first week of each month) ❏ I would like my gift to be anonymous Payment Method: ❏ Check: $___________ (amount enclosed) Make checks payable to APMA Educational Foundation ❏ Credit Card: ❏ VISA ❏ MasterCard ❏ American Express ❏ Discover Credit Card Number: _________________________________ Expiration Date: ____/______ CVV: _______ Name on Card: ______________________________________ Signature: __________________________________________ ❏ My gift is in memory or honor of someone In Honor Of: _________________________________ In Memory Of: _______________________________ Please provide us with a name and address if you would like APMA to notify the individual and/or family of the honored or memorialized person above. Email or mail this form with your contribution to: Tina Carter APMA Educational Foundation 11400 Rockville Pike, Suite 220 * Rockville, MD 20852 * tcarter@APMA.orghttp://www.apma.org/donate http://www.apma.org/donate