* Please provide at least one of the following:
* Membership: A $1,000 membership provides voting rights for one person. 2020 membership contributions are due no later than January 31, 2020.
Confidentiality and Conflicts of Interest: I understand that confidential information may be acquired as a result of my association with Impact 100 Garden State, and that this information should not be disclosed. To insure a fully transparent grant selection process, I will disclose to the leadership of Impact 100 Garden State any potential conflicts of interest I may have with grant applicants.
Please send check by 01/31/2020 to:
Impact 100 Garden State
PO Box 2114
Morristown, NJ 07962-2114