Online Donation Form

Please use this form to make a non-membership donation to Impact 100 Greater Indianapolis. This includes paying for a membership for someone else or making a donation directly to the Grant Pool without a membership. Contact us at impact100indy@gmail.com if you have any questions.
Name*
First Name Last Name
- I request that Impact 100 NOT use my name on their website and/or social media as an Impact 100 member or donor.
Email*
Mobile Phone
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Designation*
Please indicate the intent for your donation.
- Leaders of the Future Scholarship Program
- Pay Someone’s Membership
- Build the Change Maker Grant Pool
- Operational/Administrative Costs
- Where needed most
- Other (please indicate your intent in the Notes field)
Donation*
Please enter the amount of your Donation here.
Notes
Please tell us anything you want us to know about your Donation to Impact 100, especially if you are making a donation for a specific purpose, to pay someone’s membership, or in response to a specific request. If you would like to make this donation as a tribute to someone special, please let us know (please include contact information if you want us to send them a note).
Total
$0.00
Credit Card

American Express
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MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Tax Information
Impact 100 Greater Indianapolis is an IRS recognized 501(C)(3) charitable organization. Your donation is tax deductible to the full extent permitted by law.
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