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 AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code 2023 Membership Dues* OAO Membership Dues All Other Years/Renewing Members - $585 OAO 2nd Year Membership Dues - $435 OAO 1st Year Membership Dues - $292.50 OAO Resident Dues - $0 No Payment - $0 Please choose the amount due from your invoice. If you are not paying any dues today, select No Payment.Scope Education and Advocacy Contribution (optional 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. 2023 PGC Registration - Optional Price: $450.00 Quantity: Total $0.00 Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name EmailThis field is for validation purposes and should be left unchanged.