Supporter Registration Form

1
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2
Address:* This field is required.
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Afghanistan
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Algeria
American Samoa
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eSwatini
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Syria
Taiwan
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Tonga
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3
Phone Number:* This field is required.
Area Code
Phone Number
4
E-mail* This field is required.
example@example.com
5
Disclosure: Contributions or gifts to Delta for Women In Action, Inc. are NOT deductible as charitable contributions for Federal income tax purposes.
6
SUPPORTER LEVELS
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My Bag
0
My Bag
Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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Great Product Name
$20
Quantity:1
Size:Small
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ORDER SUMMARY
Total costUSD
$25 - Hemmings Supporters (College Student)• Our semiannual D4 Women newsletter • A beautiful E-Certificate of Membership suitable for framing, that recognizes your participation as a Supporter • Email updates about D4 Women in Action news.
$25.00Edit
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$50 – Hamer ContributorsAll of the above, plus: • Recognizes your participation as a Contributor.
$50.00Edit
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$100 – McLeod AssociatesAll of the above, plus: • Recognizes your participation as an Associate.
$100.00Edit
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$250 – Terrell FriendsAll of the above, plus: • Recognizes your participation as a Friend.• Your name listed on the website • An exclusive D4 Women in Action acknowledgment.
$250.00Edit
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$500 – Shabazz BenefactorsAll of the above, plus: • Recognizes your participation as a Benefactor • D4 Women in Action lapel pin• An exclusive D4 Women in Action acknowledgment• Special invites to D4 Women in Action programs and activities.
$500.00Edit
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$1,000 – Height DonorAll of the above, plus: • Recognizes your participation as a member of the Donor Circle • D4 Women in Action lapel pin • An exclusive D4 Women in Action acknowledgment • Special invites to D4 Women in Action programs and activities
$1,000.00Edit
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$2,500 – Jordan Donor’s Circle All of the above, plus: • Recognizes your participation as a member of the Donor's Circle Plus• D4 Women in Action lapel pin• An exclusive D4 Women in Action acknowledgment• Special invites to D4 Women in Action programs and activities • Speaking invitations at D4 Women in Action programs and activities.
$2,500.00Edit
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$5,000 - Chisholm Donor's Circle PlusAll of the above, plus: • Recognizes your participation as a member of the Donor's Circle Plus• D4 Women in Action lapel pin• An exclusive D4 Women in Action acknowledgment• Special invites to D4 Women in Action programs and activities • Speaking invitations at D4 Women in Action programs and activities.
$5,000.00Edit
Back
Total cost $0.00
7
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