NLA PAC Contribution Form

Thank you for your support of the NLA Political Action Committee!
*** Please note***

1) You must be an NLA member in the United States to contribute to the NLA PAC

2) Contributions MUST be made from personal (not corporate/business) funds.
Name*

First NameLast Name
Company*
E-mail*
On behalf of my company, I give the NLA PAC permission to solicit my company’s restricted class for contributions from 2025-2029. I understand that corporate approval is necessary before the NLA PAC may conduct a solicitation and my company may not approve solicitations by another trade association for the same calendar year.
Permission to solicit:*

Yes, I give the NLA PAC permission to solicit me for PAC contributions.
Public Recognition for Contribution*

Yes, I give NLA PAC permission to publicly recognize my contribution (Only your name will be used, NOT your contribution amount)No, I do not give NLA PAC permission to publicly recognize my contribution (Only your name will be used, NOT your contribution amount)

Contribution Amount*

USDDescription

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Personal Funds Acknowledgement*

I certify that I am an NLA member in the United States and my contribution is being made by personal funds, not corporate.
Please verify that you are human*
Should be Empty:

Thank you for your support of the NLA Political Action Committee!