PLEASE PRINT THIS FORM BY CLICKING THE "PRINT ICON"  BELOW.

Complete the hardcopy form and fax or mail to the addresses below.

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I am making a gift of: $5, $15, $25, $250 or Other $___

Please use it for  _________________________,

or r where most needed.

Your Name: _______________________________________

Your Company/Organization: _______________________________________

Street Address: _______________________________________

City/State/Zip: _______________________________________

Phone Number: _______________________________________

Email Address: _______________________________________

Check or Credit Card Information

Name on Card: _____________________________________________

Card Type: _____________________________________________

Account Number: _____________________________________________

Expiration Date: _____________________________________________

and

Mail to:
Volunteers of America Oregon
3910 SE Stark Street, Portland Oregon, 97214

Fax to: 503-239-6233
Volunteers of America Oregon
Attn: Web Donations