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Sponsor or donate

The Alaska Academy of Physician Assistants is a non profit organization. Sponsorship from corporations are welcome! Download a list of sponsor benefits here. Donations from individuals are welcome and will be put towards general operations. 
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Donation

* Mandatory fields
*First name
*Last name
*Professional Designation
Organization
*e-Mail
*Cell Phone
Home Phone
Preferred Mailing Address
City, State
Zip
Work Phone
Work Mailing Address
Work City, State
Work Zip
*Specialty
*Are you and AAPA member?
AAPA number
Would you like to be contact about precepting for MEDEX?
Would you like to be added to a PA shadow database?
*Amount ($USD)
Business Name
Please fill out this field if this is a corporate sponsorship.
Business Address
Please fill out this field if this is a corporate sponsorship.
Business City/State
Please fill out this field if this is a corporate sponsorship.
Business Zip
Please fill out this field if this is a corporate sponsorship.
Business Phone
Please fill out this field if this is a corporate sponsorship.
Business Fax
Please fill out this field if this is a corporate sponsorship.
Number of PAs employed at organization
Please fill out this field if this is a corporate sponsorship.
Comment

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