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2020 MEMBERSHIP FORM BY MAIL-IN CHECK
Please make check payable to Impact100 DC. Mail your check to Impact100 DC, PO Box 40121, Washington, DC 20016
Would you like to be added to the Impact100 DC email list?
This will allow you to receive our monthly newsletter and other important Impact100 DC updates.
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Your $1,000 membership contribution goes in total to funding the grant. Member Plus contributions of $1,100 as well as any additional amount you enter in the third, customized option are highly appreciated and help defray essential operating expenses in this all-volunteer organization.
$1,100 - Join as a Member Plus and help us with essential operating expenses
$1,000 - Join as a full Member
I WOULD LIKE TO VOLUNTEER!
Contact me for help with:
Technology (website, database management)
Grant Review Committees
I would like to serve on a Grant Review Committee:
Health and Wellness
Arts and Culture
How did you hear about Impact100 DC?
From a member of Impact100 DC
From a member of another Impact100 chapter
Word of mouth
Name of Impact100 DC member:
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.
Mail check to:
Impact100 DC, PO Box 40121, Washington, DC 20016