People For Libraries - WCCLS Levy Renewal 2025

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First Name

Last Name

Phone

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Address

Address 2

Postal Code

City

State / Province

Occupation (or retired)

The Oregon Secretary of State's office requires that your employment information is submitted with your donation.

Employer Name

Or "N/A" if not employed

Employer City and State

Or "N/A" if not employed

Please fix the errors above.

Credit number

MM / YY

CVC Code

The 3-4 digits on the back of your credit card

Billing Postal Code

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