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Wildfire Fire Member Assistance Application
In light of wildfire's impact throughout Oregon, SEIU 503 is offering one-time financial assistance of up to $250.00 to help members and their families impacted by fire and evacuations. Please fill out the form below to apply.
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1.
Financial assistance will only be made available to SEIU 503 members in good standing.
(Required.)
I am a SEIU 503 member
I am filling this out on behalf of an SEIU member
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2.
Name
(Required.)
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3.
Email
(Required.)
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4.
Best Phone
(Required.)
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5.
Mailing Address
(Required.)
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6.
Please tell us how you would like to receive payment
(Required.)
Paypal - FASTEST OPTION
Paper check via mail - Checks will be sent to mailing address above
Other (we will try to accommodate other payment arrangements)
7.
If you select to receive payment via Paypal, please confirm the email address associated with your Paypal account.
8.
Please briefly describe how you have been affected by wildfire this year.
