ChiroThon Donation – Foundation for Chiropractic Progress

Please Consider a ChiroThon Donation

Doctors, if you donate $180 or more, you will be upgraded to a one year Foundation Membership, which gives you access to even more resources to help you market your clinic. (Does not apply to current ANJC Group Members.)

Donation Amount*
Enter Donation of $500 – $250 – $180 – $100 -$50 or another amount
Name*
First Last
And I am a*
- Doctor of Chiropractic
- Staff member of Chiropractic office
- Consumer supporter of Chiropractic
Practice / Association / Company name
Email*
Phone*
Your phone number will only be used to contact you if there was a problem settling your donation with your credit card processor.
Credit Card Information*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Street Address Address Line 2 City State ZIP Code
Total
$0.00

Please Consider a ChiroThon Donation

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