2025 Committee Registration Form

Impact100 Sonoma 2025 Grant Review Committee Registration
First Name*
Last Name*
Email Address*
Mobile Phone Number*
Please use the format: xxx-xxx-xxxx
Have you paid your Impact100 Membership dues for 2025?*

YESNOT YET
What is your membership Status? (Hiatus = Returning from hiatus)*

NEWRENEWINGHIATUS
RENEW YOUR MEMBERSHIP, OR JOIN HERE!
Have you had prior experience on one of our Grant Review Committees? Please check all that apply:*

YESNOFINANCIAL REVIEW
Do you feel comfortable with our Foundant grant management software?

YESNOMay need a refresher
Are you NextGen (Impact100 considers members 45 and under to be Next Gen)?*

YESNO
Please select ALL of the following pairs of dates you would be AVAILABLE for meetings. You must be available for BOTH dates in order to select that pair. These meetings are to be held in-person. Days and times of Site Visits will depend on your individual committee.

We will notify you of your committee assignment in January.

If you cannot commit to ANY pair of dates, please do not sign up. Please consider signing up next year.
Select the PAIRS from above that you are AVAILABLE and mark in your calendar:*

TUES Feb 11 & Mar 18 4-6:30 PMWEDS Feb 12 & Mar 19 10AM-12:30THUR Feb 13 & Mar 20 4-6:30 PMSAT Feb15 & Mar 22 10AM-12:30
You are required to attend a grant training session. Please select the training session you plan to attend and put in your calendar:*

Thur Jan 30 4 PM-6PMSat Feb 1 10 AM-12 PM
In this next section, you will be asked if you understand and accept the roles and responsibilities of being a GRC Member, and Impact100's Values and Equity Commitment.

These documents are also available on our website here: GRC Resources

Finally, you will be asked to read and acknowledge our Confidentiality and our Conflict of Interest Policies, as well as list any conflicts of interest you and family members may hold.

Please check the appropriate box as you read each policy:
Scroll through document to read in full.
Scroll through document to read in full.
CONFIDENTIALITY POLICY: Grants and Financial Review Committee members do not share evaluations or discuss proposals outside of our assigned review committee. We are impartial, and do not lobby others on behalf of an applicant. Except for site visits, we do not engage with or privately contact applicants during the grant cycle.*

AGREE
CONFLICT OF INTEREST POLICY: All Impact100 Sonoma Grant and Financial Review Committee members commit to acting with integrity in all of our relationships and in selecting grant recipients through an equitable process. In support of this commitment, we ask for you to disclose affiliations for yourself and your immediate family with nonprofits serving Sonoma Valley. We ask you to provide information on these relationships in our registration form so that we can place you on a committee without conflicts. We also require a committee member to recuse herself from the discussion and/or vote on any topic where a conflict arises.*

AGREE
If you or a family member is affiliated as an officer, director or employee of a nonprofit offering services in Sonoma Valley, please list them here:
NONPROFIT NAME, POSITION HELD, FAMILY MEMBER NAME (e.g., La Luz, BoD, Self)
Please select any Sonoma Valley nonprofits for which you actively volunteer, and list additional ones in the space allotted:

Boys and Girls ClubFISHJack London ParkLa Luz CenterSonoma Community CenterSonoma Overnight Support (SOS)Sonoma Valley Mentoring AllianceOther
Your signature indicates that have accepted Impact100's confidentiality and conflict of interest policies.*

Clear
Please select the "Review" button below.

NOTE: You will know you have successfully registered if:

1. You immediately see a green "Thank You" envelope

AND

2. You receive a confirmation email from "Jotform" (check spam folder)
Should be Empty:

Impact100 Sonoma 2025 Grant Review Committee Registration