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Membership 110%: $1,000 fuels grants; $100 supports gatherings and costs

Membership: $1000 to Grants

Please check the box below if you wish to have your membership renew automatically each year.

I understand that conhdential information may be acquired as a
result of my association with Impact100 Garden State and that this information should not be disclosed.
To ensure a fully transparent grant selection process, I will disclose to the leadership of Impact100
Garden State any potential conmicts of interest I may have with grant applicants.
I agree that my image may be used in photographs to promote Impact Garden State via its website, on
social media, and in other materials. If you do not wish to be included in the listing, please email:
member@impact100gardenstate.org.

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Membership 100%

Membership 110%

I would like my membership to Automatically renew annually (Evergreen)

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Eligible for a matching gift?

Yes, I plan to submit my Impact100 Garden State gift for a matching gift donation

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Fund Transfer / Third Party Name

Payments by third parties on your behalf such as those administering Donor Advised Funds, other charitable funds, IRAs or investment accounts should be made directly to Community Foundation of New Jersey (EIN 22-2281783) to the attention of Madeline River

Fund Transfer / Third Party Name: If your donation method is via a Fund Transfer or Third Party (Employer, Outside Sponsor, Donoradvised Fund, etc.), please provide the name of the fund manager or third party and initiate the transfer as soon as possible.

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I would like my membership to Automatically renew annually (Evergreen)

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