LAO PAC Donation Form

All of the fields below are required for PAC reporting purposes.

Please complete the information below:

First Name:
Last Name:
Profession:
Home Address:
City: State: Zip:
Phone:
Personal Email:

Please accept my PAC gift of:

ACKNOWLEDGMENT:

By checking here I acknowledge that this credit card is from my personal account and NOT one for my employer or business. I also understand that PAC donations are NOT tax-deductible.
Thank you for supporting the LeadingAge Ohio Political Action Committee!
   - denotes required fields

Our national partner, LeadingAge, is an association of 6,000 not-for-profit organizations dedicated to expanding the world of possibilities for aging. Together, we advance policies, promote practices and conduct research that support, enable and empower people to live fully as they age.