Women of Impact Membership Form

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THE MEMBERSHIP FORM needs to be completed each year. You can complete the form online below or

2021 Women of Impact Membership Form

I am a*
*
First
*
Last
Corporation Name (if joining as Corporate Member)
Home Address*
Street Address Address Line 2 City State ZIP Code
Home Phone
Cell Phone*
Email*
Current Occupation*
I am joining as (choose one):*
- A Corporate Member ($1,000 Annual Commitment)
- A General Member ($500 Annual Commitment)
- A Shared Member ($250 Annual Commitment)
- An Associate Member, 18-30 years old ($100 Annual Commitment)
Additionally,
- I am a General Member who would like to Sponsor a Member, listed below.
- I am a Shared Member and my Member Partner's name is listed below.
- I am an Associate Member and my sponsor's name is below.
Name
By signing below, I am committing to contributing based on my membership level chosen above to join the Women of Impact Boone County. This includes a contribution for the Women's Fund endowment fund at the Community Foundation of Boone County plus the applicable number of quarterly contributions (dependent on join date) to the nonprofit organization chosen by the membership of the Women of Impact at each quarterly meeting. I agree to honor my commitment even if I am not present at a meeting, my charity was not chosen and/or I am not in favor of the organization chosen. If I choose to pay my annual membership on a quarterly basis and am unable to attend a quarterly meeting, I understand that my credit card will be charged for that quarter's donation.
Online Signature*
CLICK HERE to pay your annual membership fee online, select "All other CFBC funds and registration", and select "Women of Impact Membership" from the list of endowment component funds. If you need to split up your annual fee into quarterly payments, contact Julie Reagan at the email address below. Alternately, you can download and print the form from the link at the top of this page and submit with payment to the address below OR bring with you to the next WOI meeting.

Any questions, contact Julie Reagan at jreagan@communityfoundationbc.org or 765-482-0024.

Community Foundation of Boone County
Women of Impact
102 N. Lebanon St. Suite 200
Lebanon, IN 46052
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Thank you to our 2021 sponsor for supporting us. Sponsorships cover behind-the-scenes costs to ensure that 100% of membership dollars go right back out into the community.