Become a Member

If you would like to become a member and join us quarterly to make an immediate, direct and positive difference in our community, please fill out the form below. This is the first step in making a BIG impact!

Date(Required)

Date form completed and submitted

Name(Required)

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Please enter the best phone number to reach you

Email(Required)

example@example.com

Event Photos

Please read each statement and click the circle that applies to you.(Required)

I give permission for 100 Neighbors Who Care Penobscot Valley to use pictures of me for promotional purposes.

I DO NOT give my permission for pictures of me to be used for promotion.

Commitment Agreement

Please read each statement and check each box to indicate your agreement.(Required)

I am committing to donate $400 per year ($100 per quarter) to local 501(c)3 charities serving the Penobscot Valley area.

I agree to fulfill my donation commitment even if I did not vote for the charity chosen at each quarterly meeting.

I understand that I am still obligated to make my quarterly donation within 7 days even if I do not attend the quarterly meeting.

I opt in to receive communications about upcoming quarterly meeting news and events. And understand that unsubscribing means I may miss important information regarding my membership or 100 Neighbors Who Care.

This field is for validation purposes and should be left unchanged.