Take Action — 100 Women Who Can

become a member

By completing the form below, I acknowledge that I understand that in joining "100 Women Who Can - Farmington Valley" I am making a commitment to contribute $400 per year ($100 per meeting) to worthy charities and non-profits serving Hartford County.

I agree to honor my commitment even if I did not vote for the charity chosen by majority vote.

I agree to honor my commitment even if I am not able to attend the meeting. I will either send my check with a friend or I will mail it immediately following the announcement of the recipient.

Name

First Name

Last Name

Email Address

Phone

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Questions or Comments

nominate a nonprofit

Member Name

First Name

Last Name

Member Email

Name of Organization

Organization Contact Name

First Name

Last Name

Organization Contact Phone

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Organization Contact Email

Local Organization Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Local Organization Website

http://

If this is a national organization, do they have programs specific to Hartford County?

Is this organization a 501(c)3 nonprofit?

Does the organization agree that it will not use, give or sell the contact information of our members for additional solicitation by them or other organizations?

Does the organization agree to provide individual receipts to each contributor for tax purposes?

In your own words, please tell us about the good work this organization does in Hartford County.