Nebraska Hospital Association

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

The NHA PAC thanks you for your support. The NHA PAC is committed to shaping the discussions and policy issues that impact our patients, employees and communities. By investing in the NHA PAC, you are helping Nebraska hospitals and health systems to positively impact the election of political candidates who recognize and support health care's important role in the state.

For additional information, please contact David Slattery, Director of Advocacy, (402)742-8153.

Contribution Levels
1898 Society:	$5,000
Champions Club:	$2,500 - $4,999
Ben Franklin Club:	$1,000 - $2,499
Chairman’s Circle:	$500 - $999
Capitol Club:	$350 - $499
Other:	$0 - $349

Contribution Amount:

Choose A Frequency

Recurring Frequency:

Total: $0.00

Donor Information

First Name: *

Last Name: *

Hospital Organization: *

(To receive credit for your donation)

Occupation Title: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *

Country: *

Telephone:

E-mail: *

A receipt will be e-mailed to this address.

Comments/Questions:

ALL MAJOR CREDIT CARDS ACCEPTED

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