100 Women Who Care Rural Wellington Charity Nomination Form
Please note only members of 100 Women Who Care Rural Wellington can nominate charities.
Email address *
Member Name: *
Your answer
Name of Charity: *
Your answer
Address of Charity: *
Your answer
Website of Charity: *
Your answer
Mission Statement of Charity: *
Your answer
The charity serves the following population: *
Your answer
The charity is a registered charity able to provide tax receipts: *
If selected, someone from the charity will be available to speak at our next meeting to describe the impact of the donated funds. *
The charity agrees not to sell, give or use the 100 Women Who Care Rural Wellington contact information for solicitations. *
If selected, cheques should be made payable to: *
Your answer
Date of nomination: * *
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A copy of your responses will be emailed to the address you provided.
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