Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone (C) *

(###)

###

####

Phone (H)

(###)

###

####

I understand that *

I will be receiving necessary organization emails.

I understand that *

I am making a commitment to 100+ Women Who Care Midcoast Maine to make an annual donation of $200 - ($50 at each quarterly meeting) – to be given directly to local nonprofits serving the Midcoast Maine area.

I understand that *

even if I do not vote for the nonprofit chosen by majority vote, I will fulfill my donation commitment.

I understand that *

if I am not able to attend a quarterly meeting that I will provide my check to another member to deliver at the meeting, or I will mail a check to the address below or I will donate through the 100+ Women Who Care Midcoast Maine account on Grapevine by credit card.

I understand that

my donation needs to be received within 2 weeks following the meeting.