100 Women Who Care North Platte -- Registration & Commitment Form  

    Commitment:  With my completion and electronic submission of this form, I am agreeing that the information I provide below is accurate and true.  I am pledging to participate in 100 Women Who Care North Platte, and I am making a personal commitment to contribute $400 each calendar year ($100 quarterly) to local nonprofit organizations serving the North Platte area.  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 OR will pay by check or online payment through Mid-Nebraska Community Foundation.  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 Who Care North Platte.  I understand that my personal contact information is strictly confidential and will not be shared or distributed to an outside third party without my expressed consent.