Membership Form

I wish to become an Impact100 member! Members may join at any time. The deadline for the membership fee payment and $1,000 contribution to the grant award pool (allowing voting for next year’s grants) is December 31st. Those joining between January 1st and the June Awards Celebration may participate in all Impact100 events, but will have voting rights for the following year.

Renewing Members:  If your information has not changed this year, please print your name and email address and write “same” on the mailing line.  Otherwise, provide updates as needed.

STEP 1: Membership Fee
This fee is used to offset events and administrative expenses. (Tax deductible)
Note: We are in the process of adding an option to pay online via credit card. This will be available shortly.
STEP 2: $1,000 Contribution to Grant Award Pool
There are multiple options to make your tax-deductible contribution by December 31, 2018. Please indicate which you prefer:
Additional Ways to Make $1,000 Contribution:
I will transfer $1,000 from my donor advised fund.
I acknowledge that neither I, nor anyone related to me, will receive material benefit from this grant if distributed.
My company makes matching charitable gifts. I will followup with the paper work.

Optional Sign Up

I am interested in learning more about one or more of the following Committees. For more information on the committees, see

Please choose your areas of interest:
I can contribute time in other areas (indicate interest):
I grant permission to Impact100 Metro Denver to use my name and email on: electronic and printed donor lists, the Impact100 website and other Impact100 Metro Denver publications. I agree that my email will be used as the primary means of communication by Impact100.

Please Note:  Membership information is used solely for the purposes of Impact100. If you do not wish to have your name or image used please send an email to:

If you have any questions, please do not hesitate to contact a member of the Board of Directors, or email us at

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