Impact100 Baldwin County

First Name *

Last Name *

Email *

Are you new to Impact 100 Baldwin County, or are you updating your information?
Choose 1

Organization Legal Name *

Organization DBA Name

Organization Phone *

Organization Email *

Organization Mailing Address *

Executive Director Name

Executive Director Email

Executive Director Phone

Name of additional member of your organization to receive Impact 100 emails

Position in the Organization of additional member of your organization to receive Impact 100 emails

Email of additional member of your organization to receive Impact 100 emails

Phone of additional member of your organization to receive Impact 100 emails

Non-Profit website

Do you consent to receiving the Impact 100 Baldwin County monthly Newsletter via email? *

Yes

Nonprofit Contact Information Form