Online Membership Form

  • Please use this form to join Impact 100 Greater Indianapolis. Contact us at impact100indy@gmail.com if you have any questions.
  • Membership Level: Full or Shared

    100% of your Membership Donation goes into the Grant Pool and is given back to our community in the form of Grants each year. Impact 100 Greater Indianapolis is an IRS recognized 501(C)(3) charitable organization. Your donation is tax deductible to the full extent permitted by law.
  • If you wish to be a full member, please CLICK IN THE BOX BELOW TO SELECT THE LEVEL OF MEMBERSHIP DONATION YOU WISH TO MAKE. Please consider joining our Friends and Supporter members who give an additional amount to help cover our Administrative costs, or at least adding $35 to help pay our credit card fees.-
  • If you wish to be a FULL MEMBER, please SELECT THE LEVEL OF FULL MEMBERSHIP DONATION YOU WISH TO MAKE. Please consider joining our Friends and Supporter members who give an additional amount to help cover our Administrative costs, or at least adding $35 to help pay our credit card fees. (NOTE: If you wish to make a partial payment of your membership donation, please skip to Partial Payment.)
  • We allow a partial payment of your Membership of at least $250 with the remainder to be paid before December 31. Please enter the amount of your partial payment here, and use the Notes field to tell us when you will pay the remaining amount. You may break the remainder into one or two payments, and ask to be invoiced on October 1 and/or December 1. Remember, the full amount of your Membership must be paid by December 31. You will not receive a tax acknowledgement until the full amount is received.
  • If you wish to be a part of a Shared Membership, CLICK IN THE BOX BELOW TO SELECT THE LEVEL OF SHARED MEMBERSHIP DONATION YOU WISH TO MAKE. If you know the names of one or more of the women with which you wish to share your membership, please enter their name(s) in the Notes field. Otherwise, we will group you with other women who have requested a Shared Membership.
  • If you wish to be a part of a SHARED MEMBERSHIP, please select the LEVEL OF SHARED MEMBERSHIP DONATION you wish to make below, then consider joining our Friends and Supporter members who give an additional amount to help cover our Administrative costs in the next section. If you know the names of one or more of the women with which you wish to share your membership, please enter their name(s) in the Notes field. Otherwise, we will group you with other women who have requested a Shared Membership.
  • Our Shared Members often contribute extra to help pay administrative fees. Please check the appropriate box if you wish to make that contribution.
  • Some of our members make additional donations to our Young Philanthropists Scholarship Fund. These donations increase the Grant Pool AND pay the membership fees for a local young woman who would not be able to participate in Impact 100 without these scholarship funds. Enter the amount you would like to donate in the field below.
  • Please use the Notes field to give us more information regarding your Membership and/or Donation choices.
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