Pledge Information

The Foundation is a 501(c)(3) nonprofit organization registered with the Internal Revenue Service. A copy of the official registration and financial information may be obtained from the PA Department of State by calling toll-free within Pennsylvania 1-800-732-0999. Registration does not imply endorsement.

First Name:

Last Name:

Home Address:

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Phone No.:

Email:

PAFP Affiliation:

Other Affiliation:

Donation Amount:

Donation Allocation:

Planed Giving

I am interested in including the Foundation in my estate planning, such as leaving a donation in my will or making a deferred gift.

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Payment Options

If paying by check, please make all checks payable and deliver to:
PA Academy of Family Physicians Foundation
3915 Union Deposit Road #447
Harrisburg, PA 17109

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Name on Card:

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Billing Address:

Same as Home Address

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Matching Gift

Many employers will match your gift. This match can double and sometimes triple your support of the Foundation. Check with your human resources office and if a match is available, please send the matching gift form to PAFP Foundation at the address noted above.

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