OAO Payment/Contribution OAO Dues Payment/Contribution Form Practice* Name* First Last Email* Address (please enter new address if you have moved)* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 2022 Membership Dues* OAO 1st Year Membership Dues - $292.50 OAO 2nd Year Membership Dues - $435 OAO Membership Dues All Other Years/Renewing Members - $585 OAO Resident Dues - $0 No Payment - $0 Please choose the amount due from your invoice. If you are not paying 2022 dues today, select No Payment.Past Due or Other Amount Scope Education and Advocacy Contribution Support OAO and our continued efforts to educate Legislators on the risk of unnecessary and risky scope expansion. Contributions are not deductible as business expenses.PAC Contribution (optional amount) Oregon Foresight Ophthalmology PAC contributions support OAO’s legislative efforts to maintain access to safe, quality eye care and assure that surgery is performed only by MDs and DOs. PAC contributions are credited for the calendar year in which you contribute. 2022 PGC Registration - Optional Price: $435.00 Quantity: Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20222023202420252026202720282029203020312032203320342035203620372038203920402041 Expiration Date Security Code Cardholder Name NameThis field is for validation purposes and should be left unchanged.