Join Impact100 Essex

Thank you for committing to our organization and the many nonprofits we support through our Impact and Equity Grants. Membership is an annual $1,150 tax deductible donation, with $1000 designated directly to our grantees, and $150 going to support our chapter's operating expenses.

Joining happens in two steps:

Step 1. If you are new and joining for the first time, fill out the "Membership Form" on this page. Please note fields marked * are required.

If you are renewing, please click here now: RENEW MY MEMBERSHIP

Step 2. After you fill out this form and press "Submit", please follow the instructions on the next page and pay your membership dues. Please hit submit on the second page as well. You will receive a welcome email indicating your membership form was received!

Membership Level:

Impact100 Membership - $1,150

Impact100 Essex - Fellowship (by invitation)

First Name: Last Name: Company: Email: Preferred Phone: Home Address: City: State: Zip: -

Payment Options

All payments are made to, and through, the Community Foundation of New Jersey (CFNJ), Impact100 Essex's fiscal sponsor. CFNJ Tax ID/EIN is 22-2281783.

Please select from the options below

I will mail a $1,150 check made payable to the Community Foundation of NJ and note "Impact100 Essex/IMPESX" on the memo line. Mail to CFNJ, Attn: Impact100 Essex/Alicia Nager, P.O. Box 338, Morristown NJ, 07963.

I will pay by stock transfer.

I will make a grant through a Donor Advised Fund (DAF).

I will pay online by credit card.

I will pay online, in installment payments by credit card. Full payment due by December 31.

WOULD YOU LIKE TO MAKE AN ADDITIONAL DONATION? Support Fellowships/sponsored members and increase our granting ability.

$250

$500

$1150

Other amount

GIFT MATCHING:

Yes, through my employer.

Yes, through my partner's employer.

No.

I'm not sure.

If yes, please tell us the name of your or your partner's Employer

Optional - please take a minute to tell us about yourself and your volunteer interests.

How did you hear about us?

Friend

Social media

Local print/online ad

Other

Referred by a member? Please tell us who. Self identification (please check all that apply). We strive to understand how our membership reflects Essex County.

Asian American/Pacific Islander/Asian

Black/African American/African

Hispanic/Latino/Latina/Latinx

Native American/American Indian/Indigenous

White

Multi Racial/Multi Ethnic

Other

If you checked other above, please tell us about yourself. Age range

Under 30

30-45

46-60

61-75

75+

Please use the space below to tell us about your professional and/or volunteer experience and skills. I am interested in the following Committees/working groups:

Membership and Events (member recruitment, member engagement, event planning)

Communications (member communications, press communications/social media, website content)

Grants (grant administration, grant software, nonprofit relations/engagement)

Grant Review (review applications from nonprofits with a team of members)

Governance (succession planning, organizational practices)

Finance (financial reporting, nonprofit financial review)

Confidentiality Agreement and Conflicts of Interest Statement

Confidential information regarding members and nonprofits may be acquired as a result of membership with Impact100 Essex. This information may not be disclosed.
Members electing to participate in grant review will disclose any potential conflicts of interest to ensure a fully transparent and fair process.

Terms of Agreement - Confidentiality and Conflict of Interest

I have read and agree to all terms outlined in the Impact100 Essex Confidentiality and Conflicts of Interest Statement.

Photo Release Statement

Photographs taken at Impact100 Essex events which contain member images may be published electronically or in printed material for the purpose of promoting Impact100 Essex.

Terms of Agreement - Photo Release

I agree to allow Impact100 Essex to use photos as described.

I do not agree to allow Impact100 Essex to use photos as described.