g3 Membership Class of 2023-2024 Registration

Membership Deadline: Friday, September 15, 2023

Thank you for your interest in Girls Giving Grants (g3)! We are so pleased you've decided to make a bigger impact through our collective giving efforts. This form requires you fill out all the information and to pay your $125 Annual Membership Contribution.

If you are requesting a scholarship or sponsorship please apply here. Questions can be emailed to g3@impactaustin.org.

Student Information

First Name

Last Name

Student Email

Email Type

Student Phone

Phone Type

Additional Information

School Information

Name of School

Grade Level during 2023-2024 year

Voluntary Self-Identification

Impact Austin's Diversity, Equity, Inclusion, and Belonging (DEIB) efforts are designed to help us better represent the communities in which we operate. Any information you provide will be handled confidentially, and used in aggregate to track our progress toward our DEIB goals. Please check the appropriate racial/ ethnic category:

Select Racial / Ethnic Identity

Birth Year

Please enter a 4 digit numerical year (e.g. 1968)

Are you a new member or renewing?

Parent / Guardian Information

First Name

Last Name

Email

Email Type

Phone

Phone Type

Parent/Guardian is an Impact Austin member (not required):

YesNoNot a requirement for membership

Member Pledge

Participants in g3 agree to:

Make my very best efforts to attend in full, all regularly scheduled meetings. I understand that each g3 member may be allowed two (2) excused absences. I also understand that after my third absence, I may not be allowed to vote on the grant finalist.
Be at all meetings on time.
Treat everyone with respect.
Give 100% effort in my participation.
(NEW MEMBERS) To submit my conflict of interest, media release & liability waiver documents with my guardian's signature within 30 days. (RETURNING MEMBERS) To update previously submitted permission documents if changes need to be made.

By typing my full name below, I am agreeing to abide by the above participation policies:

Membership Contribution

Annual Membership Contribution - $125 per year plus applicable credit card processing fees. All fees are contributions to Impact Austin, no refunds will be issued.

Donation

Make a bigger impact by giving an extra donation to additionally support the general operations and infrastructure required to support the Girls Giving Grants program (g3).

Payment Details

Membership Fee

$

Donation Amount

$

Credit Card Fees:

$

In order to process gifts made via credit card, Impact Austin works with a payment processor that charges us a required fee of 2.9% per gift.

Total Due Today:

$

Billing Address

Payee

Who's Name is on the Credit Card?

Address Line 1

Address Line 2

City

State

Zip Code

Credit Card

Name on Card

Billing Email

Your receipt will be emailed here.

Card Number

MM

YY

Code