Donate Now to the Administrative Fund

Please enter all fields below to make a one time or monthly contribution via credit card or bank draft.

The administrative fund accepts businesses and individual contributions. State and local chapters can also contribute. Money in this account goes to the operating costs of HUPAC so that the candidate fund can be reserved solely for political contributions. Unlike the candidate account, there are no contribution limits on the administrative account.

Your Information

First Name

Middle Name

Last Name

Occupation

Employer

Address 1

Address 2

City

State/Province

Zip/Postal Code

Phone

E-mail

Suggested Contribution Levels for Candidate Fund

	One Time	Monthly Payment
Supporter	$150	$12
365 Club	$365	$30
Congressional	$500	$42
Senatorial	$750	$63
Capitol Club Levels
Gold	$1,000	$85
Diamond	$2,000	$170
Double Diamond	$4,000	$250
Triple Diamond	$5,000	$415
Other	$	$

**These guidelines for contributions are merely suggestions. You may contribute more or less than the guidelines suggest, and the National Association of Health Underwriters (NAHU) will not favor nor disadvantage you by reason of the amount of your contribution or your decision not to contribute.

Payment

Credit Card Payment By:

Visa MasterCard AmEx/Optima Discover

Card Number

Exp. Date

OR.....

Payment By:

Bank Draft

Bank Account Number

Routing Number