100 BTC Membership and Commitment Form

Membership and Commitment Form

Please complete this form to become a member of 100 Businesses That Care - Greater Phoenix. By joining us you are committing to make an annual donation of $1000 per year ($250 per quarter) to local 501(c)3 charities presented and voted on by our membership.
Member Information
Company Name *
Your Name *

First Name Last Name
Position *
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Mobile Number *

Area Code Phone Number
Email *
example@example.com
How did you hear about us? *
If you heard about us through a member or charity, please include their name.
Event Photos
Please read each statement and click the circle that applies to you. *

You have my permission to publish pictures of me on the 100 Businesses That Care Greater Phoenix website, social media outlets and media and news outlets. You DO NOT have my permission to publish pictures of me.
Commitment Agreement
Please read each statement and check each box to indicate your agreement. *

I understand I am making a commitment to 100 Businesses That Care Greater Phoenix to make an annual donation of $1000 per year ($250 per quarter) to local 501(c)3 charities serving the Greater Phoenix area. I agree to fulfill my donation commitment even if I did not vote for the charity chosen at each quarterly giving circle. I understand that I am still obligated to make my quarterly donation, even if I do not attend the giving circle. If I am unable to attend a quarterly giving circle, I will ensure my donation is received by the chosen charity immediately following the giving circle and before the next quarterly giving circle. I understand that as a member I will be added to an email list in order to receive communications about upcoming giving circle news and events. I can update my communication preferences at anytime, but if I choose to unsubscribe from the list I will not be informed of important information regarding my membership or 100 Businesses That Care Greater Phoenix
Signature *

Please sign above with your finger (on tablet or mobile) or mouse (desktop). Clear
Date *

Month Day Year
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Membership and Commitment Form

Member Information

Event Photos

Commitment Agreement