Registration & Commitment Form:

I agree that the information I provide below is accurate and true.  By checking the signature box below, I pledge to participate in 100 WWC - Medinah, and make a personal commitment to contribute $400 each calendar year (at this time, $100 in April, June, August and October) to local non-profit organizations serving our area.  I agree to donate each quarter to the non-profit organization selected by the group’s majority vote.  If I am unable to attend a meeting, I will either:

  1. Send my check with another attending member to deliver (and vote) on my behalf
  2. Mail my check as requested after the meeting
  3. Pay online directly to the charity, if that option is presented.

**The only opportunity to give your voting powers to another member is to send a check with that member to the meeting.

Thank you for investing your time and monetary commitment to 100 Women Who Care!

Name *
Name
Address *
Address
Best Phone Number *
Best Phone Number
Cell, Home or Work
Phone Type
Signature *
Checking the box below serves as my signature and commitment.
Photo Release *
I acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for 100 Women Who Care.
Membership Directory *
I understand my personal contact information is strictly confidential and understand it will not be shared or distributed to an outside third party without my expressed consent. If 100 Women Who Care- Medinah chooses to publish a Membership Directory, I agree that my contact information be included in that directory.