Membership Commitment Form

Membership Commitment Form - 100 Men Peterborough

Thank you for your interest in joining 100 Men of Peterborough!

Please fill out the form below. This information is needed for planning purposes, for the meetings and for receipts from the organizations that will receive the donations.

I understand that I am making a commitment to 100 Men of Peterborough to make an annual donation of $420 ($105 at each of the four meetings), which will be given directly to local charities, non-profits and organizations serving the Peterborough area.

By signing below, I acknowledge that my name and picture may appear on the 100MenPeterborough.ca website, Facebook page & LinkedIn Profile

Name

Street Address

City

Postal Code

Primary Phone

Alternate Phone

Occupation

Signature

Clear

Today's Date

Donation Pledge

By completing this form, I am agreeing to send $420 via E-Transfer to donations@100menpeterborough.ca. This amount will cover donations and club expenses.

If you agree with the above statement but are not able to send Interac E-Transfers, please reach out to info@100menpeterborough.ca

Maintaining Membership

My membership with the club will be contingent on contributing the respective annual amount each January.

If you are human, leave this field blank.

Membership Commitment Form

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