Join : How To Help : Impact Las Vegas Foundation, Inc.

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 below (click on Membership 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.

$1030.00
$515.00 (if making 2 payments)
$257.50 (if making 4 payments)
Other (enter $ amount)
$1,133 Member Plus
$1,236 Supporting Member
$1,545 Supporting Gold Member
$2,060 Supporting Premier Member

If "Other" please fill in Other Amount

Other Amount

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First Name (Required)

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Street Address

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City, State, Zip

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Select a Payment Method

Credit Card
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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.

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Account Type

Checking
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Make this a monthly payment?

Yes, bill my card today and on the 29th of every following month. (if the month doesn't have 29 days, your card will be billed on the last day of the month.)

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How To Help