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Staff Recipient

Alissa Parady
aparady@ihsinfo.org
571.212.8596

Advocacy Alliance Contribution

IHS provides essential advocacy functions on issues of critical importance to our members by engaging with Members of Congress, federal agencies and workgroups, and state elected officials. These activities are funded solely through the generosity of our members and organizational partners through IHS’ Advocacy Alliance. By making a contribution to our advocacy efforts , you are making a tangible difference in the strength of our programs, which, in turn, go to work for you and the future of your practice. Please contribute today by making a one-time donation, or becoming a member of our Monthly Donor Club*. You can use the webform below or download and send your completed donation form.

Contact Info

Name (First, Middle, Last)

Email

Address

City

State/Province

Zip/Postal Code

Phone

Fax

Contribution Amount Payable

To contribute, check the box that indicates your level of support.
$2500 Leadership Circle
$1000 President's Circle
$500 Governor's Circle
$250 Capitol Club
$100 Statesman's Society

Other Amount for Contribution

Confirm Contribution Amount

*Monthly Donor Club members and Leadership Circle donors receive extra recognition and a special gift.

Frequency of Donation


One-time donation (your credit card will be charged the amount indicated above one time)
Monthly donation (you authorize your credit card to be charged the amount indicated above once a month until you indicate otherwise)


Designation of Funds (Optional)

I'd like to designate my donation to help:
OTC Defeat Fund (Over the counter hearing aids)
IHS' Fit to Serve efforts


Payment Method

We accept American Express, Discover, Mastercard & Visa.

Name on Card

Card Number

Expiration Date