100 Women Who Care Grimsby-Lincoln
MEMBER REGISTRATION FORM
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Phone Number *
Membership *
I understand that I/we am/are making a commitment to 100 Women Who Care Grimsby-Lincoln to make an annual donation of $400 ($100x4) or a team commitment amount (Team of 2 or 4) given directly to the charities of choice that serve the Grimsby-Lincoln Communities.
Clear selection
I agree to donate regardless of my attendance at the quarterly meeting. *
Required
I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote.
 *
Required
I understand that photos may be taken at meetings for use on the website, promotion and social media and give permission for my likeness to be used. *
Required
I agree to have my contact information included in the 100 Women Who Care Grimsby-Lincoln Membership List and be contacted by 100 Women Who Care Grimsby-Lincoln by email. 100 Women Who Care Grimsby-Lincoln collects your personal information (name, email, address and phone number) strictly for the purpose of maintaining our membership list seen only by the 100 Women Who Care Grimsby-Lincoln Committee. 100 Women Who Care Grimsby-Lincoln will not sell, give or otherwise share your personal information without your consent, unless required by law. We also request that the chosen charities not give out any member information to any third parties except for tax purposes.  *
Required
How did you hear about 100 Women Who Care Grimsby-Lincoln?
Clear selection
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms