HSCO Membership Form

How to join the Human Services Coalition of Oregon

Levels of Support *

Sustaining Member $500: For organizations representing more than 100 employees or 100 dues-paying members. Smaller organizations are also welcome to join HSCO at this level of support. Individuals who represent organizations of this size are also encouraged to join HSCO at this level.

Organizational Member $200: For organizations representing up to 100 employees or 100 dues paying members. Individuals representing organizations of this size are also encouraged to join HSCO at this level.

Individual Member $65: For those human service advocates who are not formally affiliated with a human service provider or advocacy coalition, or others who simply support our work.

Required

Organization Name *

Contact Name *

Address *

City, State, Zip *

Email for Main Contact *

Phone *

How do you plan to pay your dues? *

Mail a check payable to HSCO to: PO Box 3094 Wilsonville, OR 97070

Pay Online: https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=R548H6CWNQHLY&source=url

Is there another contact that we should email future invoices to? ( Answer No and we will email invoices to the main contact above. If there is another contact, please provide name and email) *

Are there other members of your organization you would like added to our mailing list? Please provide email addresses. *

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