AFEI Giving Circle Enrollment Form

Ambassadors for Economic Independence

Giving Circle Enrollment Form
Ambassadors for Economic Independence is comprised of active members dedicated to raising 1 million dollars to empower women throughout the Washington region to emerge from economic instability through collective giving and community-based grant making. Each member will contribute a minimum of $1,000 within a one-year period.
Enrollment Date*

MonthDayYear
Today's Date
Name*

First NameLast Name
Birthdate*

MonthDayYear
Birthdate
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Daytime or Cell Number
Please select your giving circle level:*

Monthly - $84Quarterly - $250Bi-Annually - $500Annually - $1,000
Please select the committee you would like to chair or join:*

FinancePublic RelationsEvaluation & ImpactEducationEventsGrants
Please verify that you are human*
Should be Empty:

Ambassadors for Economic Independence