Nominate a Non-Profit Charitable Organization Name * Contact Name * First Name Last Name Contact Phone * (###) ### #### Contact Email * Nominating Member's Name * Nominating Member's Email * Organization Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Organization Mission/Purpose * When was the organization started? Organization's Website If the organization is chosen how will the funding be used? If the organization is selected how many people will be served by donated funds? Is the organization a registered 501(c)(3) charitable organization? * Yes No If selected, would someone from the organization be available to speak at our meeting to describe the impact of the donated funds? * Yes No Does the organization agree NOT to sell, give, or use the 100+ Women's contact information for solicitations by themselves or other organizations? * Yes No Does any portion of the contribution go toward administrative fees? * Yes No Does your organization serve the Waupaca Community? * Yes No Thank you!
