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Check if the contribution is from spouse or immediate family member
First Name *
Please do not enter middle initial.
Last Name *
ASA Member No.
To use another address for this PAC Contribution please do the following:
Note: Changing your address WILL change your address for all ASA communications
to update your ASA Primary Address
2) After updating your address click on ASAPAC
3) Click on Contribute
State and Zip
Armed Forces Americas
Armed Forces (Africa, Canada, Europe, Middle East)
Armed Forces Pacific
District of Colombia
Occupation * (please no abbreviations)
(please no abbreviations)
One Time Contribution
Circle of Distinction donor
level is $500 - $999.
Chairman's Council donor
level is $1000 and above.
Maximum contribution is
$5000 per calendar year.
Guideline Amounts are Merely
(Clear All Donation
Recurring contributions will be valid for a minimum of 12 months and a maximum of 24 months.
Your first contribution will occur today and the remaining contributions will be made the same date every month.
The selected amount will be charged each month to your credit card.
For this type of contribution, the credit card expiration date should be
greater than or equal to the date you select for termination of contribution.
You have the option of canceling this process at any time by contacting Michelle Mathy at email@example.com.
$41.67 (Circle of Distinction Club Level)
$83.34 (Chairman's Council Club Level)
I would like this contribution to automatically recur:
*recurring contributions can be no more than 24 months.
(Corporate and Business Credit Cards Prohibited.)
Type of Personal Credit Card
Credit Card Number *
*Do not include dashes or spaces
Name on Card *
Please check if you wish to receive an ASAPAC pin.
Note: The ASAPAC
Fiscal Year runs from October 1st to September 30th.
Contributions to ASAPAC
are not deductible as charitable contributions for federal income tax purposes.
Participation in ASAPAC is voluntary. You may refuse to contribute without reprisal.
Questions or comments regardng
ASAPAC may be directed to Michelle Mathy in the ASA Office of Governmental and Legal
202-289-2222 ext 140 or firstname.lastname@example.org
Please check the boxes below
to confirm that the following statements are true:
I am making this donation from my own funds, not those of another, and through my
personal credit or debit card for which I have a legal obligation to pay, and not
through a corporate or business entity card or the card of another.
I am at least 18 years of age, and I am a U.S. citizen or legal permanent resident
of the U.S. residing in the U.S. and a current dues paying ASA member.
Retired members are also permitted to contribute to ASAPAC.
Note: Due to
new security policies for some credit card issuers, please contact your card issuer
if your transaction fails.
We are not able to process a contribution for you. Please contact ASA at (847) 825-5586.
ASA Political Action Committee
1061 American Lane
Schaumburg, IL 60173-4973