Commitment Form | 100 Women Who Care

Please use the form below to indicate your Commitment to 100 Women Who Care Burlington. If you are making a Commitment as part of a team, each person should provide their information by filling out the form below and use the Additional Notes section to communicate how the $100 donations will be split between team members.

If you are human, leave this field blank.

Name - Please also Include Team Name if signing up as a Team *

Email *

Address *

City *

Postal Code *

Phone Number *

How did you hear about 100 Women Who Care Burlington?

Additional Notes

I understand and agree with the below statement *

Agree

I understand that I am making a commitment to 100 Women Who Care Burlington to make an annual donation of $400 – ($100 at each of four meetings) – given directly to a local charity or one of it's valuable programs that serves the Burlington community. I agree to fulfill my donation commitment even if I did not vote for the charity selected by majority vote. I also agree that I will provide my cheque to another member to deliver in my place if I am not able to attend a quarterly meeting.

I agree to have my contact information included in the 100 Women Who Care Burlington Membership Directory

Agree

Should you wish to discontinue membership at any time, please send an e-mail to info@100womenwhocareburlington.com indicating your withdrawal.