MSCA Political Action Committee (PAC)

2010-2011 PAC Application

Click here to download this application as a PDF file

Membership Year:  July 1, 2010 - June 30, 2011

Please fill-out, print and mail to:

MSCA PAC
220 E. Dunklin
Jefferson City, MO 65101

Select MSCA PAC Membership Level

Select One Ambassador $1000 Scholar $750 Diplomat $500 Emissary $250 Regular $120

Ambassadors are a prestigious group of chiropractic physicians committed to the advancement of chiropractic.  Ambassadors have their names added to a plaque at MSCA Central Office in Jefferson City, are recognized at the PAC Reception during the MSCA Summer Convention, and receive a gift from MSCA PAC.

$250 Quarterly / $1000 Annually

Scholar members are a distinguished group of chirpractic physicians committed to the advancement of chiropratic. Scholards receive special recognition at teh PAC reception during the MSCA Summer Convention.

$187.50 Quarterly / $750 Annually

Diplomats are a dedicated group of chiropractic physicians committed to the advancement of chiropractic.  Diplomats have their names added to a plaque at MSCA Central Office in Jefferson City, and are recognized at the PAC Reception during the MSCA Summer Convention.

$125 Quarterly / $500 Annually

Emissary members are a special group of chiropractic physicians who give something extra to help support the advancement of the chiropractic profession.

$62.50 Quarterly / $250 Annually

Regular members are chiropractic physicians who actively support the advancement of the chiropractic profession.

$30 Quarterly / $120 Annually

After you have paid your annual PAC membership, purchases at any PAC-sponsored event apply toward reaching the next higher level of membership.  Certain individual political contributions may also apply toward reaching the next level of membership.  MSCA membership is not required to become a PAC member.

Method of Payment: Select One Annual (check or credit card) *Semi-Annual (credit card) *Quarterly (credit card)

Method of Payment:  Convenient payment plans are available.  Dues can be automatically charged to your credit card semi-annually or quarterly.

*Important:  For your convenience, automatic credit card charges continue annually.  You may call to cancel at any time.

Charge $ ________to my Visa MasterCard Discover

Make checks payable to MSCA PAC.