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100 KIDS
About
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MEMBER
Events
Contact
100 KIDS
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100 Women Tri-Cities BC Registration and Commitment Form
First Name
Last Name
Email
Address
City
PROVINCE
POSTAL CODE
Phone
Date
I understand my personal contact information is strictly confidential and will not be shared or distributed to an outside third party without my expressed consent. If 100 Women Tri-Cities BC chooses to publish a membership directly, I agree that my contact information can be included in that directly.
Yes
No
I agree that the information I have provided is accurate and true. I am pledging to participate in 100 Women Tri-Cities BC, and I am making a personal commitment to contribute $400 each calendar year ($100 quarterly) to local non-profit organizations serving the Port Moody/Coquitlam/Port Coquitlam region. I agree to donate each quarter to the non-profit organization selected by the group’s majority vote. If I am unable to attend a quarterly meeting, I will either send my cheque with another attending member to deliver on my behalf, mail it as requested after the meeting, or pay online, if that option is presented. I also acknowledge that photographs and videos taken at events and meetings may include my image and may be used in promotional materials for 100 Women Tri-Cities BC.
I agree
Yes, I would like to sign up to receive updates and special event news via email.
Yes
Submit