2025 Midyear Meeting PAC Prize Donations Form

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

Donations to fund PAC prizes can be either personal or business funds.

Name(Required)
Email(Required)
Please include dashes for phone number entry. Ex: 123-456-7890
Suggested Contributions(Required)

These contribution amounts are suggested amounts only and your participation at the PAC reception is voluntary. Your level of contribution or non-participation in this event will have no impact on other business you have with CMHA. Cash cannot be accepted.

Your order invoice will be created and forwarded to you via email. If you have any questions, please contact Sheila Thomas, 571-224-0937.

For questions about the event, contact Erin Hobson, 703-657-6908 or Dana Hartung, 703-457-1107.

For questions about the PAC Programs, contact Fred Adams or Adrienne Heidema.