Member Information Form

$1,100
MEMBERSHIP

$1,000 goes towards grants, while $100 helps to cover administrative expenses. To participate in the 2025 grant cycle, donations must be received by December 31, 2024. 

To maintain accurate records, Impact100 Greater Wausau asks donors to submit a new membership form each year.

Paper copies are available. For your convenience, you may also use the form below to submit the information electronically before or after mailing your check.

Please mail your check to:

Impact100 Greater Wausau
PO Box 1554
Wausau, WI 54402