Texas Society of Anesthesiologists

TSAPAC Contribution

Categories of TSAPAC Membership:

Diamond ≥ $1,000 OR $84/month
= $750 OR $62.50/month
= $500 OR $42/month
= $250 OR $21/month
Retired Diamond
= $100
Resident Diamond
= $100
= $20

Contributions may be made as a one-time payment or divided into monthly payments. The above amounts are based on 12 months, starting in Sept. For help determining monthly payment amount, see 

Enter Your Contribution Per Payment Amount
and then Select a Payment Option:

The TSAPAC fiscal year runs from Sept. 1st- Aug. 31st,
all contributions payment options are paid in full by Aug. 31st.

Per Payment Contribution Amount: $

Single Payment of amount entered above.        
3 Monthly Payments of amount entered above.
  1 Quarterly Payments of amount entered above.

Enter 'Y' here if you would like to be a sustaining member
and continue your contributions year to year without having to re-subscribe.
Contributions can be changed or cancelled at anytime by calling the TSA office.

Political contributions to TSAPAC are voluntary.  The TSAPAC supports office holders and candidates for election to state offices who understand the importance of organized medicine and the specialty of Anesthesiology.  No portion of any contributions to TSAPAC may be deducted as a business expense for federal income tax purposes.  Contributions to TSAPAC will be reported as required by law.  The TSAPAC may accept individual and professional association (PA, PC or LLC) contributions only.

TSAPAC Contribution Payment Form

* Designates Required Information

Member Name *
Name on Card *
Card Number *
Security Code (CVC) * (located on back of card)
Expiration (MM / YYYY) * /
Telephone no. *
Address 1 *
Address Line 2
City * / State * / Zipcode * / /
Email Address *