100+ Who Care of Warren County Membership Commitment Form 2021
2021 Meetings   5:30pm - 6:30pm

January 5th
April 6th
July 6th
October 5th

Conger Construction Group
2020 McKinley Blvd
Lebanon, Ohio  45036
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Last Name *
First Name *
Email Address *
Phone Number *
Mailing Address *
Employer
Registration Type *
How did you hear about 100+ Who Care of Warren County *
I am pledging to participate in 100+ Who Care of Warren County and I am making a personal commitment to contribute $400 each calendar year ($100 quarterly) to a local nonprofit organization serving Warren County, Ohio. (Student $100 each calendar year, $25 quarterly)  I agree to donate each quarter to the nonprofit organization selected by the group's vote.  If I am unable to attend a quarterly meeting, I will ensure my $100 ($25) is submitted.   *
Required
I understand my personal contact information is strictly confidential and I understand it will not be shared or distributed to an outside third party without my expressed consent.  If 100+ Who Care of Warren County chooses to publish a Membership Directory, I agree that my contact information shall be included in the directory. *
I acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for 100+ Who Care of Warren County *
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