Charity Nomination Form
100 Women Who Care STC Charitable Organization Nomination Form

Please note that by completing this form, you acknowledge the understanding that as a member you and nominated organization are prohibited from using membership information for future solicitations or any other public use or purpose.
Date *
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DD
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Name of Nominated Organization *
Your answer
Is the Organization registered 501c(3) organization? *
Organization's Contact Name *
Your answer
Address *
Your answer
Phone Number *
Your answer
Email Address *
Your answer
Mission Statement of Organization *
Your answer
What population do they serve? (children, women, elderly, etc.) *
Your answer
How would the funds be used? *
Your answer
If selected, would someone from the organization be available to speak at following meeting to describe impact of donations? *
Name of Nominating 100WWC Member *
Your answer
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