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How To Help



Fill out this online Membership Commitment Form and pay online (please include 3% additional for transaction fee costs so that 100% of your membership donation will be part of the grant award).

OR download the form, fill it out and mail it with your Membership donation check, minus the 3% fee, (payable to Impact Las Vegas) to P.O. Box 15797, Las Vegas NV  89114)

Membership Donation (f paying by credit card -- all shown amounts include 3% processing fee)
If making a monthly payment, divide the total Membership Level amount (i.e., $1030) by the # of months left in the calendar year. Select Other and enter this amount in the Other Amount field.
If "Other" please fill in Other Amount
Please enter amount
Street Address
City, State, Zip
Preferred Phone Contact #
Select a Payment Method
Visa MasterCard American Express Discover

Visa®, MasterCard® & Discover® cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

American Express® cardholders
Your security code is the 4-digit code located above the actual credit card number on your card's front.

Make this a monthly payment?
Make this a monthly payment?
Your payment will be