This is only a preview. No submissions will be saved, nor will emails be sent.
I want to join the 5,000 Strong!
Name
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
First Name
A value must be entered before continuing.
Last Name
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
Region
*
A value must be entered before continuing.
East Lane
Eugene Area
McKenzie River
North Lane
South Lane
Springfield Area
West Lane
Outside Lane County
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
If you are not sure what region you live in, find your zip code at the bottom of the page and select the corresponding region. Not a Lane County resident? Select "Outside Lane County"
Organization
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
Mailing Address
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Address Line 1
Address Line 2
A value must be entered before continuing.
City
A value must be entered before continuing.
State
A value must be entered before continuing.
Zip
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
While not required for joining 5,000 Strong, if you provide your address, we will send you a collectable sticker!
Phone
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
Email
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
I commit to the following to support 90by30
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Like&Share 90by30 on Facebook
Follow 90by30 on Instagram
Receive 90by30's e-newsletter
Volunteer my time and talent
Invite 90by30 to Present
Share with Friends and Family
Attend a meeting near me
Volunteer for a Strategy
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
Check all that apply! Strategies include Welcome Baby Bundle, Roots of Empathy and Parent Cafés. You can also volunteer your time and talent in other ways, including knitting hats for Welcome Baby Bundles or behind-the-scenes work at the annual conference!
Consent to Public Recognition?
*
A value must be entered before continuing.
Yes
No
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
If you do not wish to be publicly acknowledged for your contribution/commitment through our website, newsletter or other publications, please select No. If you select Yes or leave this field blank, you agree to public acknowledgment as outlined above.
How did you learn about us?
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.
Any additional comments?
*
A value must be entered before continuing.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
Invalid Email Format
A value must be entered before continuing.
$
A value must be entered before continuing.
A value must be entered before continuing.
Please choose one of the above options to continue.
Please choose one of the above options to continue.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A value must be entered before continuing.
A donation amount must be chosen before continuing.
$
A non-zero value must be entered before continuing.
A value must be entered before continuing.
A non-zero value must be entered before continuing.
A value must be entered before continuing.
One Time
Recurring
Please choose one of the above options to continue.