Impact 100 Membership Form
*For making my non - refundable, tax - deductible contribution to Impact 100 Palm Beach County for the 2019 - 2020 grant year:
To remit payment, please call our office at (561) 336 - 4623
*As a voting member, I am interested in actively participating as a volunteer on the following committee(s):
I grant Impact 100 Palm Beach County permission to publish my name and photo in the listing of members contained in the program for the Annual Awards Event and other promotional materials.
A copy of the official registration and financial information for Impact 100 Palm Beach County Inc., a Florida-based nonprofit corporation (Registration No. CH60185), may be obtained from the Division of Consumer Services by calling toll free 1-800-HELP-FLA (435-7352) within the state or visiting their website at www.freshfromflorida.com. Registration does not imply endorsement, approval, or recommendation by the state. Federal Tax ID Number: 82-4558049.