With my signature below, I am agreeing that the information I provide below is accurate and true. I am pledging to participate in 100 Women Who Care Ames and make a personal commitment to:

• Contribute $100 at each quarterly meeting during the year ($100 X 4 meetings) to local nonprofit organizations serving Story County, Iowa, which will be selected by the group's majority vote. I agree to donate at each meeting to the nonprofit organization selected by the group's majority vote.

• If unable to attend a meeting, I will either send my check with another attending member to deliver on my behalf, mail if requested after the meeting, or pay online if that option is presented within seven (7) days of the meeting. I realize only members in attendance are able to vote.

• Acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for 100 Women Who Care Ames.

• If I wish to discontinue membership, I will send an email to: 100AmesWomen@gmail.com

• I understand my personal contact information is strictly confidential, and I understand it will not be shared or distributed to an outside third party without my expressed consent.