Forms

100(+) Women Who Care Motown

Commitment Form

Please Print:

Name________________________________________________________________________________

Street Address_________________________________________________________________________

City, State & Zip________________________________________________________________________

Phone (H)_______________________(W)________________________(C)_________________________

Email Address:_________________________________________________________________________

I understand that I am making a commitment to 100+ Women Who Care Motown to make an annual donation of $400 – ($100 at each quarterly meeting) – given directly to local charities, non-profits and other worthy causes serving the Detroit area. I understand that even if I did not vote for the charity chosen by the majority vote, I will fulfill my donation commitment. I also understand that if I am not able to attend the quarterly meeting that I will provide my check to another member to bring to the meeting or will mail my check or make my on-line donation within 5 days of receipt of the winning announcement email.

In order to be a potential presenter, member must have attended two meetings before being allowed to deposit a charity for potential nomination. In addition, only one ballot per charity will be allowed to be deposited into the hat and the first member who nominates that charity will present on their behalf.

My commitment will automatically renew, for successive quarterly periods, unless notice is given.

Signature_______________________________ Date_____________

I agree to have my contact information included in the 100+ WWC Membership Directory. Please check:

Yes_______ No________

Karen.Rashid-Balow@RaymondJames.com

Commitment forms may be completed and turned in at a meeting.

The 100+ Women Who Care Motown thanks you for your support!

Nominating Form

Nominating Member’s Name: ________________________________________________________

100+ Women Who Care

Motown

CHARITABLE ORGANIZATION

FACT SHEET

Name of Charitable Organization

_____________________________________________________________________________________________

Address: (Headquarters and where services are provided, if different)

_____________________________________________________________________________________________

Web address of organization:

_____________________________________________________________________________________________

When was the organization started?

_____________________________________________________________________________________________

Mission Statement of the Organization:

_____________________________________________________________________________________________

How would the donated funds be used?

_____________________________________________________________________________________________

What are the current sources of funding for the Organization?

_____________________________________________________________________________________________

What population does the Organization serve? (children, women, elderly, mentally ill, etc.) AND

how many people will receive services annually (Approximately if known)?

_____________________________________________________________________________________________

Is the Organization a registered 501(c)(3) (IRS Certified Tax Free Status) charitable Organization?

Please Note: while a non 501(c)(3) organization is still eligible for consideration, contributions will not

be tax deductible so therefore Members must be aware of this status prior to voting.

_____________________________________________________________________________________________

If selected, would someone from the Organization be available to speak at our next meeting

to describe the impact of the donated funds?

_____________________________________________________________________________________________

Does the Organization agree not to sell, give, or use the 100+ Women’s contact information for

solicitations by themselves or other organizations?

_____________________________________________________________________________________________

If this charity is selected by the group, to whom would the check be payable to?

_____________________________________________________________________________________________

Does any portion of a contribution go toward administrative fees?

_____________________________________________________________________________________________

To be completed by Member leadership post donation:

Meeting Date: _____________________________________________________________________

Chosen Charity: ___________________________________________________________________

Did a representative from the chosen charity present at the following meeting to describe the

impact of the donated funds? Please describe:

_____________________________________________________

_________________________________________________________________________________

How much money was actually collected and donated to the charity? __________________________

I, _______________________________________ representative of _______________________________

(Name of representative) (Name of charity)

acknowledge our understanding that the we are prohibited from using membership information for

future solicitations or any other public use or purpose:

Signature: __________________________________________________________________________________

Date: ______________________________________________________________________________________