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 *

Month Day Year
Today's Date
Name *

First Name Last Name
Birthdate *

Month Day Year
Birthdate
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State

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

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

Finance Public Relations Evaluation & Impact Education Events Grants
Please verify that you are human *
Should be Empty:

Ambassadors for Economic Independence