100 Women Who Care - Registration & Commitment Form

Registration & Commitment Form
With my signature below I am making a commitment to join 100 Women Who Care,
Greater Nashua Chapter and pledge to contribute $400 each calendar year ($100 quarterly) to the selected local nonprofit organization serving the Greater Nashua Area. Three (3) times each year a local nonprofit organization will be selected by majority vote to receive my donation. One (1) quarterly payment each year will automatically be donated to BridgesNH.org - The Flagship charity for the Greater Nashua Chapter. If I am unable to attend a meeting, I will either send my check with another member to deliver on my behalf, mail it as requested, or pay online, if that option is presented. Only members who are current in their contributions are eligible to vote. This is not an annual commitment and I understand that I will be a member until I submit my resignation in writing. I also acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for the Greater Nashua Area Chapter.
I understand my personal contact information is strictly confidential and I understand it will not be shared or distributed to an outside third party without my expressed consent. If the Greater Nashua Area Chapter chooses to publish a Membership Directory, I agree that my contact information be included in that directory.

YesNo
Member
Full Name:

First NameLast Name
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Company Name:
Company Match:

YesNo
Email:
example@example.com
Best Phone:
Please enter a valid phone number.
Signature:

Powered by Jotform SignClear
Today's Date:

MonthDayYear
Date
Should be Empty:

Registration & Commitment Form

Member