Impact 100 Indy

2025 Membership Form

Registration form heading

Step One: Your Information

Title

* First Name

* Last Name

Preferred Name

* Email

* Mobile Phone

* Address

* City

* State

* Postal Code

Employer

Step 2: Membership Level

* Level of Membership

I wish to be a Friend of Impact as well as a Member and will add additional funds to my Membership Donation to help pay administrative expenses.

Special Membership Information: Provide any additional information about your membership you think we should know. This includes names of women in your Shared Membership or if you want us to assign you to a Shared Membership.

Step 3: Payment Plan

* Select when you plan to make your membership payment.

Step 4: Payment Method

* Select the method you wish to use to make your donation. Links for making your payment(s) are in the right margin.

Additional Information: Enter anything to ensure we designate your donation properly, such as names of any members included in your payment, name of employer if an employee match, name of the bankfinancial institution or foundation sending a check.

Step 5: Member Participation

I wish to serve on a Committee (Focus Area Committees are not listed; you will make your FAC choice at the end of the year).

Section 6: Demographics

We require our grant applicants to provide their demographics, and feel we should be able to provide it to anyone asking about our membership. Your answers are not stored in our database, and are collected for demographic reporting only.

Race/Ethnicity:

Age

How did you hear about Impact 100? We are curious to know how our members find us. Include members who influenced you to join.

Section 7: Submission

I understand when I click the button below to submit this information, I am confirming my intention to become a member of Impact 100 Greater Indianapolis and promising to make the required membership donation.

Donation Options

Anyone who does not wish to enter information online can contact us at impact100indy@gmail.com or Impact 100 Greater Indianapolis, PO Box 40531, Indianapolis, IN 46240, or click here for a printable membership/donation form.

Direct Payment Methods

Check Mail your check payable to Impact 100 Greater Indianapolis to Impact 100 Greater Indianapolis, PO Box 40531, Indianapolis, IN 46240. If the check is not for a membership, please include your contact information and how you wish your donation to be used.
Credit Card Click the link for the type of donation you wish to make:

Credit Card note: when entering your credit card number, you must enter the card number, expiration date, security code, and your zip code. Failing to enter the zip code at the end of that entry will cause the transaction to fail. The system prompts for the zip code, but many users seem to overlook it as part of the credit card information sequence.

2025 Full Membership Donation
2025 Shared Membership
Leaders of the Future Scholarship Fund Donation
Friends (Administrative/Operating Funds) Donation to help pay administrative costs (these donations allow us to ensure 100% of membership, scholarship and other grant pool donations go to the Grant Pool)
Non-Membership Grant Pool Donation for those who wish to add to our Grant Pool without membership

Recurring Payments via Credit Card Follow the directions on this page for setting up a Recurring Payment. We must receive the full amount of your membership donation by December 31, 2024, for a 2025 membership. Contact us at impact100indy@gmail.com if you wish to go past December 31, 2024 for your 2025 membership.
Gifted Securities Follow the directions on this page for instructions making a donation using securities.

Indirect Payment Options

There are not links for these donation types. Once you have made arrangements for one of these types of donations, please send an email to impact100indy@gmail.com with the details for the donation.

Family or Other Foundation
Donor-Advised Funds, IRAs, and other financial institutions who will send the donation from your account
Employer Match
United Way Note: United Way keeps as much as 25% of your designated donation to cover their costs. Please consider adding to your designation to make up for the amount they keep.

Invoice

Send an email to impact100indy@gmail.com with information on who should be invoiced and for how much, and where the invoice should be sent. Unless otherwise requested, any remaining amount not paid toward membership donations will be invoiced for the remaining amount on December 1 and due on December 31.

Other Payment Methods

We like to think we thought of everything, but maybe we missed one. Send an email to impact100indy@gmail.com to propose other payment methods. Please note we do not accept non-cash donations in trade for membership.

Questions?

Send an email to impact100indy@gmail.com (Please note: this is not a link... you will have to go into your email application and enter our email address-it's a limitation of this form).

Thank you for supporting The Power of Women Giving as One®.

Important information about your donation:

Impact 100 does NOT share or sell member or donor information for any reason. We do thank those who make donation beyond their membership in our annual Giving Report and on our Donor Page unless we are asked not to use a donor's name.
Impact 100 is a nonprofit, 501(c)(3) public charity and all donations are tax deductible to the extent allowed by law.
All membership contributions for 2025 Membership are due IN FULL by December 31, 2024.
Your submission of this form indicates your acceptance and agreement to the information entered on the form.

Downloads

New Member Orientation

Information to help a new (or even a returning member) understand how Impact 100 works.

Membership FAQs

Frequently Asked Questions about being a member of Impact 100 Greater Indianapolis