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PAPAC Monthly Donations

Please fill out the below form to set up a recurring PAPAC donation.

Your donations will process between the 5th of every month for the duration of your donation cycle.

If you have any questions please email Audrey Poole @ info@okpa.org

PAPAC Reocurring Donation Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Occupation(Required)

Employer(Required)

Billing Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Class Year

Graduating PA Program Name

Donation Amount(Required)

Donation Cycle(Required)

Donation Duration(Required)

12 Months

24 Months

Cardholder Name(Required)

First Last

Credit Card Number

Expiration Date

CVC Number(Required)

Signature(Required)