100 Women Who Care Stratford Registration Form
Fill form out to become a member of the Stratford 100 Women Who Care group.
Email address *
Name *
Phone Number *
Address *
City *
Postal Code *
Photo Release *
* I understand that I am making a commitment to 100 Women Who Care Stratford by donating $400 ($100 at each four, back-to-back meetings) as a Member of 100 Women Who Care Stratford. My donation will be given directly to local charities and non-profit organizations serving the Stratford and surrounding areas. I agree to fulfill my my donation commitment even if i did not vote for the charity selected by the majority. I also agree to send my donation with another member to deliver in my place, I will send it directly to the chosen charity for the evening. I understand that my donation, regardless of my attendance or vote to the selected charity, will help create the biggest impact possible. I agree to fulfill this obligation and responsibility as a 100 Women Who Care Stratford Member. *
Signature *
Date (dd/mm/yyyy)
Should you need to discontinue your membership at any time, please send an email to 100womenwhocarestratford@gmail.com with “Membership Withdrawal” in the subject line and indicate your reason for discontinuation. Thank you.
A copy of your responses will be emailed to the address you provided.
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