Membership Form

Full Name
Street Address
City, State, Zip
Home Phone
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Giving Circle

By signing below I am committing to contributing $500 per year to join my Giving Circle. This includes a $100 contribution for the Endowment Fund in the Wabash Valley Community Foundation plus four quarterly contributions of $100 to each nonprofit organization chosen by the membership of this Giving Circle. Please note in the comments if you are in Vigo County and are 40 or younger (reduced membership of $250/year, $50 per quarter). I agree to honor my commitment even if I am not fond of the charity chosen. If I am unable to attend a quarterly meeting, I will give my check (which will serve as my proxy vote) to another member to deliver on my behalf or send my check or electronic payment to the Wabash Valley Community Foundation.
Your Initials

Please remember to submit your $100 membership commitment. Checks should be made payable to the Wabash Valley Community Foundation and sent to: 200 South 8th Street, Terre Haute, IN 47807. Or, you can make an online payment by clicking herePlease note there is a $2.56 processing fee for every $100 online payment.