Flying Physicians Association
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Donation

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*First name
Middle name
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*Last name
Name Suffix
Jr, III, etc.
Medical credentials
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*eMail
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Phone
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Organization
 

ANNUAL SUPPORT DONATION

General Operation Funds
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Funds used to 1)promote FPA to physicians and physician-pilots, 2)fund non-member speakers as needed and 3)support of AOPA Safety Foundation with check at Annual Meeting.
 

PAYMENT

*AMOUNT ($USD)
Comment
Please note donations "in HONOR OF" or "in MEMORY OF" with full name and address of the person/family members if known.
FPA PROUD PIlot Shirt Donation
Fax order/donation form to 832.415.0287 or mail to FPA Apparel, 11626 Twain Dr., Montgomery TX 77356
FPA PROUD RFS Shirt Donation
Fax order/donation form to 832.415.0287 or mail to FPA Apparel, 11626 Twain Dr., Montgomery TX 77356
FPA PROUD Cap Donation
Fax order/donation form to 832.415.0287 or mail to FPA Apparel, 11626 Twain Dr., Montgomery TX 77356

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110% TEAM STATS: Participation & Donations November 1, 2014 (Week 5 )



 


  11626 Twain Dr. Montgomery, Texas 77356 | phone 936-588-6505 | fax 832-415-0287 | email: info@fpadrs.org
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