Contact Information

Name:
Billing Address:
Phone:
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E-mail:

State law requires that you report information about your employer:

Practice/Employer Name:
City:
State
PAC Donation Amount:
PAC Donation Amount - Other:
 $ 
Total:
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Upon completing the form and clicking "submit," you will be directed to PayPal to make the WSRS PAC payment. You do not have to have a PayPal account in order to make a payment.

Please note: Contributions to the WSRS PAC are not deductible as a charitable contribution for federal income tax purposes. In addition, no portion of any contributions to the WSRS PAC can be deducted as a business expense on your federal income tax returns.

INQUIRIES: Contact Debra Alderman, Executive Director, at the WSRS Office at 206-956-3650 or email debra@wsrs.org