AMBUPAC Company Solicitation Authorization - AMBUPAC | American Ambulance Association Federal PAC

Overview

Before the American Ambulance Association can solicit you and the executive and administrative personnel of your organization for AMBUPAC contributions, we first need your written permission. In granting your permission, you cannot approve a solicitation in the same calendar year by a political action committee of another trade association. This permission to solicit in no way obligates you or the executive and administrative personnel of your organization to contribute to AMBUPAC.

Name*

First Last

Email*

Company Name*

Authorization to Solicit*

I hereby authorize the American Ambulance Association (AAA) and the American Ambulance Association Federal Political Action Committee (AMBUPAC) to solicit the executive and administrative personnel of our organization. Solicitation of personnel is limited to the sale of raffle tickets and notices about in-person and virtual fund-raisers.

Years Authorized*

Select All
2022
2023
2024
2025

For which years do you authorize solicitation?

I Accept*

Electronic Signature Agreement

By creating an account for AMBUPAC (hereafter referred to as the “Company"), you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By creating an account, you consent to be legally bound by this Agreement's terms and conditions. You further agree that your use of a keypad, mouse or other device to select an item, button, icon or similar act/action, or to otherwise provide the Company, or in accessing or making any transaction regarding any agreement, acknowledgment, consent terms, disclosures or conditions constitutes your signature (hereafter referred to as "E-Signature"), acceptance and agreement as if actually signed by you in writing. You also agree that no certification authority or other third party verification is necessary to validate your E-Signature and that the lack of such certification or third party verification will not in any way affect the enforceability of your E-Signature or any resulting contract between you and the Company. You also represent that you are authorized to enter into this Agreement for all persons who own or are authorized to access any of your accounts and that such persons will be bound by the terms of this Agreement. You further agree that each use of your E-Signature in obtaining an account with the Company constitutes your agreement to be bound by the terms and conditions of the Company’s Terms of Service and Privacy Policy as they exist on the date of your E-Signature.

Electronic Signature*

Type your full legal name.

Phone

This field is for validation purposes and should be left unchanged.