Nominate

Nominator’s Name*

Nominator’s Phone*

Nominator’s Email*

Are you (the nominator) a member of 100 Who Care Cape Ann?*

No
Yes

A member of 100 Who Care Cape Ann is a woman who has submitted a recurring donation of $100 for all quarterly meetings in the current giving cycle (June 1 to May 31). If you are not a member, please complete your donation for the giving cycle before nominating.

Name of organization being nominated*

Address of organization being nominated*

Street Address City State ZIP Code

Does this organization serve Gloucester, Rockport, Essex or Manchester?*

Yes
No

Is this organization a 501(c)(3)?*

Yes
No

Organization’s website*

Organization’s tax id #

Organization Contact Name

Organization Contact Phone

Organization Contact Email

What percent of funds are allocated to providing services in Cape Ann (Gloucester, Rockport, Essex or Manchester)? Your best guess is ok.

Please describe in 1-3 sentences how a $10,000 gift would be used, if received.*

If selected for consideration at the next meeting, this information will be shown on our website under the Impact tab. Useful information includes how the gift would impact the community, and how many people would be impacted.

Are you (the nominator) available to come to the next meeting to make a short 5-minute presentation about the charity?*

Yes
No

(Please check the DONATE page for the next meeting date.)

If you cannot make the next meeting to present the charity, please indicate at which quarterly meeting you will be able to present.

Is a charity staff member available to come to the next meeting to answer questions from the members?

Yes
No

(This is not required if the nominator feels comfortable answering questions herself.)

If your nominated charity receives an award, is a staff member available to come to the following meeting to share how the money was, or will be, spent?

Yes
No

Please tell us anything else you would like to add.

Name

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

NOMINATE

Do you know a Cape Ann organization or charity that could benefit from #THEPOWEROF100?

CHARITY NOMINATION

100 WOMEN. $100. 1 HOUR. $10,000 DONATION TO A CAPE ANN CHARITY.