100+ MWC Membership Form
Thank you for your interest in joining 100+ Men Who Care - Central Louisiana!
We can make real changes in the lives of those living in our community through our combined donations each quarter.  All it takes is 4 hours of your time and $400 a year donated to local charities.
Sign in to Google to save your progress. Learn more
Email *
Full Name *
Mailing Address *
City *
Zip Code *
Cell Phone *
I am making a personal commitment to donate $400 each year, $100 at each quarterly meeting, to charities domiciled in serving those living in Rapides Parish. I understand that even if the charity chosen is not my first choice, I will donate each meeting. If I am not able to attend the quarterly meeting, I will give my check to another member to deliver to the meeting on my behalf or I will mail my check made out to the chosen charity immediately following the date of the meeting. I further understand that this commitment will automatically renew each year unless I send something in writing (via mail or email) stating that I no longer wish to be a member of this group. *
 By typing your name below, you are signing this application electronically
Clear form
Never submit passwords through Google Forms.
This form was created inside of Fostering Community. Report Abuse