Yes! I will Personally Help.

Enclosed is my donation to SWPAC in the amount of:

______$25  ______$50  ______$100  ______ $250  ______Other _______

Please print this form and send with payment to:
NASW Oregon Chapter, Att: SWPAC , 7688 SW Capitol Highway, Portland, OR 97219

Make checks payable to: 
Social Workers Political Action Committee (SWPAC)

  Name ________________________________ Email: ________________________________

  Address ____________________________________________________________________

                        street                                    city                       state         zip

   Home Phone __________________________ Work Phone __________________________

State election law requires the following:

    Business or Occupation ______________________________________________________

    Employer's Name___________________________________________________________

    Employer's Address_________________________________________________________