100 People Who Care Tewksbury Signup Form

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Commitment: With my e-signature below, I certify that I am a Tewksbury resident and that the information I provide is accurate and true. I am pledging to participate in 100 People Who Care Tewksbury, and I am making a personal commitment to contribute $400 each calendar year ($100 quarterly) to local nonprofit organizations serving the Greater Tewksbury region.

I may choose to nominate one local charitable 501(c)(3) organization per quarter, for consideration at giving events. I agree to donate each quarter to the nonprofit organization selected by the group’s majority vote.

If I am unable to attend a quarterly meeting, I will either send my check with another attending member to deliver on my behalf and optionally vote as my proxy or pay online or by mail the charity selected by the majority.

I also acknowledge that photographs and videos taken at events may include my image and may be used in promotional materials on our website and social media and/or by local media that may choose to cover the event.

I give consent to share my personal contact information with the nonprofit organization that receives our collective donation, for tax purposes only. Nonprofits are required to issue receipts and agree to not disclose our members' information or use it for future solicitations.

Email *

I understand my personal contact information is strictly confidential and will not be shared or distributed to an outside third party without my express consent. If 100 People Who Care Tewksbury publishes a Membership Directory for members’ use, I agree that my contact information be included in that directory.

Yes

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Name *

Address

Cell Phone

Do you wish to be part of a team? Note that teams of two are allowed with optional add-ons of one senior (over 65) or junior (under 21) member. *

Yes, I wish to be part of a team. I understand that my team has one nomination and one vote.

No, I will be an individual member.

Please enter the nonprofit that you wish to nominate, state "deferred" if you are unsure, or note that you wish a board member to contact you to discuss options. *

If you do wish to be part of a team, name(s) of other member(s)

Date *

YYYY

Entering my name below constitutes a signature *

Anything you wish to share with the board?

A copy of your responses will be emailed to the address you provided.

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