West Virginia Health Care Association

WVHC-PAC Online Membership Form

Please note there is a printable version of this form. You can make a one time online WVHC-PAC Contribution at the bottom of this page.

Levels of participation:

Platinum Club Member

An elite club for those committed to giving the legal maximum of $1,000 per election cycle.

Gold Club Member

Members of the Gold Club commit to giving $500 - $999 per election cycle.

Insiders Club Member

The insiders club is made up of members who are committed to giving $250 - $499 annual PAC contributions. (Only $21 per month deducted from your Mastercard or Visa will establish you as an Insiders Club member.)

100 - 100

Club Member A $100 contribution establishes you as a WVHC-PAC Club member.

Gold Medal Facility

120 bed facilities with aggregate contributions of $1,000 or more and 119 or less bed facilities with $500 or more per calendar year qualify as Gold Medal Facilities.

Request for contributions can only be made to facility management.

* Club members may elect to have monthly or one time deductions from your Mastercard or Visa account by using this printable form. To make a one-time WVHC-PAC contribution online, use the button below.

**Please note the information collected is required by Campaign Reporting Law.

You can make a one time WVHC-PAC Contribution online through Paypal here: