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SCAFP: The Voice of Family Medicine in South Caroina

FamilyDoc PAC: Online Contribution Form

Complete this simple form below and mail or fax your payment to the SCAFP. NOTE: Corporate checks cannot be accepted for contributions. Contributions are not tax-deductible.

Personal InformationRequired to meet state reporting laws
* Name
* Street Address
* City
* State
* Zip Code
* Email Address
Phone
Fax
Occupation
Employer
Indicate Membership Level
Select the contribution amount or membership level. Diamond - $1,000
Platinum - $500
Gold - $250
Silver - $125
Bronze - $50
Resident - $30
Student - $15
Enter Payment Information Select the payment method most convenient. Please note that no credit data is stored after prcessing. This transaction is encrypted for maximum security.
Select a Payment Method
Indicate Method
of Payment
 I will be mailing a check for payment. Please mail check payable to SCAFP to:
SCAFP - PO Box 312
Laurens, South Carolina 29360-0312
 Faxing credit card info to SCAFP at (864) 984-5666.

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If you have any questions, please contact

Paquita Turner, EVP
SCAFP
(800) 242-7237
scafp@prtcnet.com

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