Impact | West Seattle membership form. *required

Name *
I am committed to attending and bringing my $100 gift to each of the quarterly gatherings in 2019 *
(if you are joining mid year, please mark the dates you are committing to)
Should a conflict arise, I promise to send my $100 check within one week of the quarterly meeting. *
If you're a returning member
Address *
Phone *
Please provide your Instagram handle.