OOPAC Contribution 2022

A Strong OOPAC - Protecting and Enhancing Optometry's Future!

A target of $240 annually from each OOA member is needed to maintain a healthy OOPAC

Corporate contributions are prohibited. However, partnerships, LLCs and other unincorporated entities may contribute but must provide the name of an owner to whom to attribute the contribution. Ohio law requires that all contributors must provide their name and address regardless of the amount of the contribution and the name of their employer if the contribution is for more than $100. If the contributor is self-employed, the business name and occupation of the contributor must be provided. This form is intended for OOA MEMBERS.

Basic Information

First Name
Middle Name
Last Name
Organization
Employer Name
Address
City State Zip
Phone Fax
Email

One-Time OOPAC Contribution

 Amount to be charged:
 If 'other', please specify amount: $

Set-Up Recurring Monthly OOPAC Contributions

Check the box below to initiate automatic monthly contributions. OOA staff will contact you to confirm the monthly amount and start-date.
 Initiate monthly contributions:
Click "Next" to advance. On the following screen, be sure to hit "Submit" to finalize your contribution.
   - denotes required fields