2019 Member Registration & Commitment Form


If you want to be part of a powerful group of local women making an immediate and positive effect in our community and want 100% of your donations to go directly to a chosen charity, then please join us. Become a registered member of 100 Women Who Care Regina today!



Contact Person Information
If you are signing up as a company or group you must have a contact person. Please put their information below. If you are signing up as an individual complete the below as well.
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
Postal Code *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
By submitting this registration form, and checking the boxes below, I, (Type Full Name) am committed to being a member of 100WWC Regina for a minimum one calendar year (four consecutive quarterly meetings.)Membership continues, unless advised to the committee. *
Your answer
I am making a commitment to 100 Women Who Care Regina to make an annual donation total of $400 ($100 at each of four meetings). Payments will be given directly to the charity selected at each of the FOUR meetings. Options of payment are cash, cheque, E-transfer(to 100Women Who Care Regina)or online to the chosen charitiy. *
Required
If unable to attend and having prepaid my donation for the quarterly meeting, I can exercise my proxy online at 100 Women Who Care Regina. *
Required
I will clearly communicate with 100WWCR committee when I am unable to attend or pay my donation PRIOR to the meeting.As well as providing a proxy vote on the 100 Women Who Care Regina website. *
Required
I consent to my information being stored in the 100 Women Who Care Regina database. I understand that they will not share, sell or misuse this information and any charity chosen also agrees to not contact me in the future except to issue the official tax receipt if applicable. *
Required
I understand that my image may appear in photos and/or other media taken at our meetings which may appear on the website, print media as well as social media pages of both 100 Women Who Care Regina as well as other 100 Women Who Care Chapters and members of 100 Women Who Care social media feeds. We encourage our members to spread our news on their personal social media feeds. *
Required
I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote
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