Commercial & Legislative Contributions & District Dues

Commercial & Legislative Contributions and District Dues (Includes one individual membership)

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2024 - 2025 Commercial & Legislative Fund

(Memberships set by SDPhA C&L Executive Committee, 2023)

PHARMACY OR BUSINESS MEMBERSHIP ($500.00)

(Includes one individual membership)

Select Pharmacy or Business Membership

CORPORATE MEMBERSHIP ($1,000.00)

(Two or more stores of the same corporation)

Select Corporate Membership

Individual Membership

Select Individual Membership

$100 Level

$200 Level

Other

District Dues

Aberdeen - $20.00

Black Hills - $20.00

Huron - $10.00

Mitchell - $10.00

Mobridge - $10.00

Rosebud - $10.00

Sioux Falls - $20.00

Watertown - $20.00

Yankton - $15.00

Pharmacy or Business Fee Amount $

Corporate Fee Amount $

Individual Fee Amount $

District Dues Amount $

Credit Card Administration Fee Amount $

TOTAL CHARGE TO CREDIT CARD $

Credit Card Information

Membership fees total to $100. By placing your card information and submitting this form, you give SDPhA permission to charge $100 to your card.

An administrative fee of 3% will be applied to all transactions.

Cardholder Name *

Card Number*

Expiration Month *

Expiration Year *

CVV# *

I agree to pay the amount by the method selected above. *