Impact100 Magazine - East Bay
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Membership Application 2023 Test
Become a Member 2023 Test
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First time Member
Renewing Member: I have previously been a Member
Sponsored Member: I am being Sponsored by another Member
If this member is sponsored, please enter the name of the sponsoring member here.
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100% of the first $1,000 of every donation will be donated to fund Impact100 East Bay Grants. Select one option below.
Member Changemaker ($1,500+) Your gift of $1,500 or more will help fund operational and/or our Changemaker Grant.
Member Plus ($1,100 - $1,499) Monies above the first $1,000 will be used to offset operating expenses of our all-volunteer organization.
Member ($1,000) 100% of this donation will be applied to the Impact Grant(s).
Member Changemaker Donation Option
At least $500 of my donation goes to the Changemaker Grant with any of the remaining to operating expenses, if needed.
Use the funds where they are most needed.
Enter Full Donation
Please enter $1,000 if you are joining as a Member. If you are making an additional contribution as a Plus or Champion, please enter the full amount of your donation.
I am interested in having my membership renew automatically each year. Please have the treasurer contact me.
I am interested in volunteering
May we include your name, email, zip code and phone number in our member directory? This information will only be used for other members to contact each other regarding Impact100 East Bay. It will not be used for solicitations. May we included your name and contact information in this directory?
If a member referred you, please include her name here:
If your company matches charitable donations, please list the company name here and submit the enrollment receipt you will receive after your payment to your Company Matching Funds administrator for processing.
Please enter any additional information or comments on your experience.
By submitting below, I am allowing Impact100 East Bay to use my name and image in photographic, audiovisual, and written works. To withdraw this consent please send a message to
with your request.
Donor Advised Fund
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Please note that a 3.5% convenience fee will be added to your donation when you pay by credit card.
Supported Credit Cards: American Express, Discover, MasterCard, Visa
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Make checks payable to
IMPACT 100 EAST BAY.
Please submit this form online and mail your check to IMPACT 100 EAST BAY, PO Box 2889, Castro Valley, CA 94546-0889
Please submit your donation acknowledgement and instructions to your DAF administrator.
Our treasurer will contact you to establish a plan suitable to your needs.
We will send instructions to the email address provided above.