Commitment Form

- COMMITMENT FORM -

* Indicates required field

Name *

First

Last

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Check the boxes below to agree to the following statements: *

I understand that I am making a commitment to 100+ Men Who Care Quinte to make a quarterly donation of $100, four times per year, which will be given directly to local charities, non-profits and organizations serving the Quinte Region. I will fulfill my donation commitment even if I did not vote for the charity selected by majority vote. If I am unable to attend a quarterly meeting, I will provide my cheque to another member to deliver in my place or courier/deliver my donation in person to 100+ Men Who Care Quinte c/o Ian Press, Bayside Secondary School, 1247 Old Hwy 2, RR 2, Belleville, ON., K8N 4Z2 or Eric Fetterley, Quinte Secondary School, 45 College Street West, Belleville, ON, K8P 4G3 Photos that I am in may be used by 100+ Men Who Care Quinte for web content, advertising, etc. I understand that my name will only be used in conjunction with my photo if my submitted charity is drawn and/or is successfully selected.

Do you give permission for us to contact you about 100+ Men Who Care Quinte via email? *

Yes No

Do you give permission to have your name posted on the 100+ Men Who Care Quinte Region website and online platforms? *

Yes No

Submit

step two:

NOTE: Members can nominate their charity of choice at any time, up to a few days prior to a meeting. Just click on the
Nomination Form under Charity Info tab.

- COMMITMENT FORM -

step two:

"keepING it simple"

Need more information?