1. Legislative Involvement Fund Contribution Form

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  8. *Required Field
    A valid email address must be provided.
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  10. As a conduit, the WAFP Legislative Involvement Fund is designed to maximize the impact of our efforts to support Academy positions, such as improving access to health care and health insurance coverage, heightening awareness of the value of Family Medicine and advocating for public health improvements. Participants deposit money in individual accounts, then authorize contributions to designated candidates of their choice.
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  13. Please select your payment choice
  14. If you'd like to submit your payment online, after you click "Submit Your Contribution" below, you will be directed to WAFP's PayPal payment portal to complete your transaction. This page will give you the option to login and pay with your PayPal account if you have one, or "Pay with a Debit or Credit Card". * A PayPal account is NOT required. *
  15. If you'd like to contribute by check, please send your check to:

    WAFP LIF

    210 Green Bay Road

    Thiensville, WI 53092

Wisconsin Academy of Family Physicians  |  210 Green Bay Road  |  Thiensville, WI 53092
Phone: (262) 512-0606  |  Fax: (262) 242-1862

© 2014 Wisconsin Academy of Family Physicians

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