Member Affiliation Form
Organization *
Your answer
Point of Contact *
Main communication point for coalition partnership
Your answer
Secondary Point of Contact
Your answer
Steering Committee Delegate *
Person attending with voting power at Steering Committee Meeting (Can be the same as Point of Contact)
Your answer
Email *
Your answer
Phone *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip Code *
Your answer
Level of Financial Support *
Organizations are encouraged to give at a level that feels generous and sustainable for your organization. At the most basic level we recommend $1 per member per month or 1% of your member dues. Please feel free to call the office if you have questions.
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This form was created inside of Portland Jobs with Justice (JwJ).