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100 Women Who Care Rural Wellington Charity Nomination Form
Please note only members of 100 Women Who Care Rural Wellington can nominate charities.
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* Indicates required question
Email
*
Your email
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:
*
Yes
No
If selected, someone from the charity will be available to speak at our next meeting to describe the impact of the donated funds.
*
Yes
No
I'm not sure.
The charity agrees not to sell, give or use the 100 Women Who Care Rural Wellington contact information for solicitations.
*
Yes
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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