Membership Form Sullivan Giving Circle - Student Signup Form Name First Last High School AttendingNorth Central High SchoolSullivan High SchoolUnion High SchoolAnticipated Graduation Date Month Day Year If a College Student, Please Type in Name of College or University Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Home PhoneCell PhoneCommentsStatusSelect an OptionI am a new memberI am renewing my membershipRequiredPlease Select a Giving Circle100+ Women Who Care - Sullivan CountyBy signing below I am committing to contributing $100 per year to join the 100 Women Who Care Sullivan County Giving Circle. This includes a $20 contribution for the Endowment Fund in the Wabash Valley Community Foundation plus four quarterly contributions of $20 to each nonprofit organization chosen by the membership of this Giving Circle. I agree to honor my commitment even if I am not fond of the charity chosen. If I am unable to attend a quarterly meeting, I will give my contribution (which will serve as my proxy vote) to another member to deliver on my behalf or send my contribution or electronic payment to the Wabash Valley Community Foundation.Your Initials Date MM slash DD slash YYYY Please remember to submit your $20 membership commitment. Contributions should be sent to the Wabash Valley Community Foundation and sent to: 200 South 8th Street, Terre Haute, IN 47807. Or, you can make an online payment at https://wvcf.org/donate/. TweetShare675