REGISTERED CHARITY NOMINATION FORM

As a member of 100+ Women Who Care Mid-Island you have an opportunity to nominate a registered charity—located in  Ladysmith, Nanaimo, Lantzville, a community in-between or Gabriola Island—to receive a donation of $10,000 or more. Simply fill out this form, and as long as you are a 100+ Women Who Care Mid-Island member, your Registered Charity Nomination Form will be active.

 

Your Name *
Your Name
If your Registered Charity Nomination Form is drawn and you do NOT want to present, which of the following will happen? *
If you are not at a meeting when your Registered Charity Nomination Form is drawn, which of the following would you like to happen? *