Future Fund Member Registration

Standard Profile Information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

First Name: *

Last Name: *

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Date of Birth: *

Format: 05/17/2012

Billing Address

Street: *

Additional:

City: *

State/Province: *

Postal code: *

Country: *

Telephone (home): *

Telephone (business):

Fax:

Are you on Facebook?

Annual Membership Due Structure

Age 20-29	$225.00/person
Age 30-39	$325.00/person
Age 40-49	$425.00/person

The $25.00 fee that is attached to your membership will help us continue to provide members fun, diverse and worthwhile events throughout the year.

There will be a 1% administrative fee placed on the pooled dues to partially offset the cost to operate the Fund by CACF. Please be aware our online gift processing provider places a 4% charge on all credit card transactions.

Payment Information

Payment Pledge: * I pledge a total of $ to be paid:

Payment Increment: *

Now In Full

Incrementally

Payment Type: *

Check

Credit Card

First payment due: Must be paid at sign-up
Second payment due: October 30th

Please make all checks payable to:

Charlottesville Area Community Foundation
PO Box 1767
Charlottesville, VA 22902

Public Profile Information

Image:

CACF can print my name in the FF Annual Membership Directory

My public profile can be displayed on the CACF site

Company:

TItle/Occupation:

Tell us a little about yourself:

What brought you to Charlottesville?:

Why did you decide to become a Future Fund Member?:

What is your favorite aspect of being a member?:

Favorite philanthropist or charity?:

Three things you can't live without?:

Favorite Local Hangout?:

Future Fund Member Registration

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