Membership Information

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100+ Men Who Care - Jacksonville

Email *

First Name *

Last Name *

Phone number

Mailing Address *

Which member can we thank for referring you?

I understand that I am making a personal commitment to 100+ Men Who Care - Jacksonville to donate $100 quarterly to the not-for-profit charity chosen by the majority of 100+ members. I agree that I will make each payment at each meeting. I understand if I elect to use our chosen payment system, Grapevine, I will be responsible for any processing fees to ensure the chosen charity receives the full $100 payment. Alternatively, I can pay the charity directly by check. My information will never be sold or shared with others outside our team.

Yes, I understand.

No, I am not able to commit at this time, but would like to be considered in the future.

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