Insurance CE

Insurance Pre-Licensing

Contact Information:

Phone: 512.343.9058

Thank you for visiting TSLA, a non-profit, trade association of excess and surplus lines brokerage and underwriting professionals. If you would like more information about our association and membership benefits, please contact us at your convenience:

phone:
512.343.9058

address:
Great Hills Corporate Center
9020-I Capital of TX Hwy N., Suite 370
Austin, TX 78759

email:
jptsla@tsla.org

information:
Info Request Form

TSLA/PAC Contribution Form

TSLA | PAC

Online Contribution

Please complete form and click submit to send PAC contribution to TSLA office. Please be sure to indicate amount you want to contribute and date you want to receive invoice. TSLA/PAC is prohibited by law from accepting corporate contributions. This is a solicitation for a voluntary contribution. Undercurrent law, contributions to the TSLA/PAC are not deductible for federal income tax purposes.

Thank You!

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General Information
Name:
Home Address:
City:	State: Zip:
Phone:
Email:
Occupation:

Please select a contribution amount below. By submitting this form, TSLA will send you an invoice (on the date you select below) via email, from which you may mail in a check payable to TSLA/PAC and sent to P.O. Box 9053, Austin, Texas 78766, or you can make a contribution with your Personal credit card (Corporate credit cards are NOT allowed.) If you would rather print a contribution form and mail a check directly, please use this link.

Contribution Amount
Contribution Amount:	"Other" Amount: $
Today's Date:
Date for Invoice:	(only if you select Invoice as Payment Method below)

Contribution Payment Method

Payment Method:

Invoice Credit Card

Total Amount Due:

Please follow instructions below if you selected "Pay by Credit Card":

If you have selected "Pay by Credit Card, please finish completing the remaining sections of this form and then press the Submit Form button. A Confirmation Submission page will then appear with a link to our ePayPolicy SECURE online payment form. Please complete the form with your CREDIT CARD information and then submit to make payment.

Card Affirmation:

Please check box to affirm that the credit card provided is a personal credit card and not a corporate credit card.

Once the credit card has been processed you will
receive a receipt by email for your contribution.

Additional Comments

Please enter any additional comments in regards to your contribution.

By pressing Submit below, you are agreeing to make a contribution to the TSLA/PAC. Please review your information for accuracy before submitting this form. TSLA is not responsible for any incorrect information entered into this form.

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