2013 GFWC-NC Remittance Form (Revised)

2013 GFWC-NC Remittance Form (Revised) Dues for the 2013 Membership Year should be postmarked by Januar y 15 th, 2013 .

NOTE: Dues must be received by headquarters in order for your club to participate in the District and State Arts festivals. NO T E : In orde r f o r you r C l u b t o b e cons i dere d f o r H ono r C l u b S t a t us , you r G F W C - NC S pec i a l des i gna ti on con t r i bu ti on m u s t b e rece i v e d b y D ece m b e r 31 , 2012 . You may remit one check for all dues and contributions; separate checks are not necessary.

M ak e chec k payab l e t o : G F W C - NC, 6050 S i x Fo r k s R d. U n i t A , R a l e i gh , NC 27609

Club Name: ______Website: ______Club President: ______Club Mailing Address: ______City: ______Zip: ______District ______Preferred Phone: ______E-mail:______Is the Club address the same as the Club President’s home address? YES NO A nnua l M e m bersh i p D ue s • Report all members, providing updated information for new and renewed members on the roster included. • Dues for all members for the club year Jan.1-Dec. 31, 2013, are $30.00, GFWC dues of $15.00 per member are included in this amount. • Dues remitted after July 1 are half-year dues and are $15 • Additional dues or contributions may be remitted throughout the year using the form found online at www . g f wcnc . o r g . District Dues are determined by each District and should be remitted to the District Treasurer, listed in the District Section of the GFWC-NC Administration Book.

Annual Dues: State HLMs ( Do no t remit dues on these members.)

Members x $30.00 = $ Total Dues Total Number of Members (including HLMs) C on t r i bu ti on s m a d e a t t h i s ti me to G F W C - NC S pec i a l D es i gna ti on s *Indicates a required donation, of any amount, for Honor Club Status. Donations must be made on or before December st 31 for Honor Club consideration. All deadlines for dues remittance, donations and reporting must also be met for your club to be considered an Honor Club.

$ *Arts Fund – interest from invested donations provides awards, scholarships, etc. for the Arts Festival.

$ *Endowment Fund – interest from invested donations enables GFWC-NC to provide services to clubs.

$ *Sallie Southall Cotten Scholarship Fund – four, four-year renewable scholarships of $6,000 per year awarded from dividends earned from invested donations.

$ *Whitener Scholarship Fund – four, four-year renewable piano scholarships at $1,500 per year are awarded from dividends earned from invested donations.

$ *Greeson-Johnson Teaching Scholarship – dividends earned from invested donations enable GFWC- NC to provide an annual $2,500 scholarship to an Education Major planning to teach K-12.

$ *General Trust Fund – funds from these savings are used to supplement the budget.

$ *1902 Society-Contributions to this designation will be considered for Honor Club Status in lieu of a donation to the General Trust Fund.

$ Honorary Life Membership – upon a $500 donation to the Endowment Fund by a club, friends, or family, recipients no longer pay GFWC-NC dues and receive a life membership pin and certificate. By April 1, send recipient’s full name, resume of not more than 250 words, whether it is a surprise, donor’s name(s) and a contact person to State HQ.

$ Women of Achievement (WOA) – Honors NC WOA and finances public image and relations projects.

$ ______Special Designations Total Page 1 2013 GFWC-NC Remittance Form C on t r i bu ti ons m a d e a t t h i s ti me to G F W C - NC P ro j ec t s Please only indicate amounts that are being contributed at the time of this remittance. Contributions made throughout the year should be remitted on the supplemental form available at www . g f wcnc . o r g . Please include contributions made directly to other organizations on your annual Community Service Program reports.

CONSERVATION $______Blue Ridge Parkway $______NC Aquariums $______NC State Museum of Natural Sciences $______NC Zoological Park

HOME LIFE $______Boys & Girls Homes $______Children’s Home Society $______Girls on the Run $______Victory Junction Developmental Disabilities Centers $______Black Mountain Center $______Caswell Center $______Murdoch Center $______O'Berry Center $______J. Iverson Riddle Developmental Center

EDUCATION $______Lucy Bramlette Patterson Scholarship $______UNC-TV

INTERNATIONAL OUTREACH $______Operation Smile of NC

PUBLIC ISSUES $______GFWC Signature Project - Domestic Violence Awareness and Prevention $______NC Transportation Museum

SPECIAL PROJECTS $______State President's/Junior Director’s Special Project (PSP) – Feed the Future $______GFWC Junior’s Special Project - Advocacy for Children

OTHER CONTRIBUTIONS $______Arthritis $______Cancer Society $______March of Dimes $______Mothers and Their Children (formerly Prison MATCH) $______Heifer International $______UNICEF $______Other: ______

$______Project Subtotal

Total Amount for Dues, Designations and Projects Submitted: $ Check Number

Club Name: E-mail: Club Treasurer: Telephone: ( ) Date:

Please contact a member of the Headquarters staff, at 800-448-8684 or 919-790-8684 or via E-mail at hq @ g f wcnc . o r g , if you have questions or concerns while completing this form. Page 2