Donations - Secure Online Donation Form

Campaign/Fund Information
Campaign/Fund * POTPAC
or Select a Different Fund
This Site Secured By SSL Encryption
Donation Information
Donation Amount *

Payment Method *
Donation Type *


Number of Payments *  
Donor Comments
Donor Information
First Name *
Middle Name
Last Name *
Suffix
Organization
Email *
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Phone *
     
Billing Information
[ Click here if billing address is the same as donor address ]
 *  
Organization 
Address *
Address Cont.
City/Town *
Country *
State
Postal Code*
Billing Phone *

Before you shop Amazon, click on the image below and bookmark the Amazon page.
Each time you shop from the linked page, Amazon sends a portion of their earned proceeds to POTA!

Pennsylvania Occupational Therapy Association | 600 West Germantown Pike, Suite 400 | Plymouth Meeting, PA 19462 | office@pota.org