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2022-23 Shared Membership - pay by credit card

PLEASE NOTE: PAY BY CREDIT CARD INCLUDES AN ADDITIONAL 3% PROCESSING FEE.

Shared Membership

 

  • Two women may form a Shared Membership.
  • Each Shared Membership is entitled to one vote in all voting procedures, including Focus Area Committee votes and the Final Grant Award vote at the annual meeting.
  • The contribution for a Shared Membership includes a $70 administrative/operational fee ($35 per person).
  • Each member should complete her own form and will receive a tax acknowledgement letter for her records.
  • The Shared Membership is official once both forms have been completed and the total $1,000 + $70 administrative fee has been paid.

 

CONTACT INFORMATION
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Address Line 2
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ZIP/Postal Code
Country
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SHARED MEMBERSHIP
Your $500 membership contribution goes in total to funding the grant. Shared memberships require an additional contribution of $70 ($35 per person) to help support operating costs. Payments by credit card incur an additional 3% processing fee ($15 per person).
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This directory is housed in a password protected space on the website. It is for the exclusive use of members and is not to be used for commercial or solicitation purposes.
I WOULD LIKE TO VOLUNTEER!

First Name
Last Name
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I hereby grant Impact100 DC, and its respective agents and assigns, the unrestricted right to use images of me from Impact100 DC events (both live and virtual) for trade, marketing, and other purposes without restriction and without my inspection or approval. I hereby release Impact100 DC and its respective agents from any legal claims or financial liability associated with such use. Do you agree to this waiver?