100+ Women Who Care Dayton Commitment Form
                                                      click here to download this form

Thank you for your interest in joining 100+ Women Who Care Dayton. To become a member, please complete this form. Your information will be kept confidential and used only for membership administration and communication purposes. Please return the completed form by scanning and emailing it to [email protected], or bring it with you to the next meeting.
Meetings are held from 5:30–6:30 p.m. on the third Tuesday of January, April, July, and October at the Fitz Center for Leadership in Community, 1401 S. Main Street, Dayton, OH 45409.
​      Together, we are making an impact through four one-hour meetings each year, with a          $100 donation at each meeting. (Please print)

Name ________________________________________________________
Street Address _________________________________________________
City, State, ZIP Code ___________________________________________
Cell Phone ____________________________________________________
Home Phone __________________________________________________
Email ________________________________________________________
I understand that by participating in 100+ Women Who Care Dayton, I am making a personal commitment to donate $400 annually, consisting of a $100 donation at each quarterly meeting, to nonprofit organizations serving the Dayton area. I also understand that I agree to donate to the nonprofit selected by the group, even if it is not my first choice. If I am unable to attend a quarterly meeting, I understand that it is my responsibility to make every effort to submit my donation by the time of the meeting. If my contact information changes or I wish to discontinue my membership at any time, I will notify 100+ Women Who Care Dayton by emailing [email protected].

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Signature ______________________________________ Date ______________