IMPACT the Palm Beaches

MEMBERSHIP FOR THE 2025-2026 SEASON IS OPEN

Fill out the form below hosted by our fiscal agent, Town of Palm Beach United Way.

Thank you for helping power positive change in our community.

If you wish to pay in installments, please call the Town of Palm Beach United Way at 561-655-1919 – they will be happy to assist you.

Please also call the United Way office if you are paying through a private foundation or donor advised fund.

You must make a selection for the payment field to appear.

2025-2026 Membership:

Annual Membership

Annual Membership - $ 1,100.00: $1,100 is tax deductible; $1,000 is added to the grant pool and $100 covers an administrative fee

(These are in addition to your Annual Membership and they are optional.)

Additional and Optional Membership Opportunities

Palm Society Annual Dues - $ 365.00: Requires paid annual membership and supports ongoing annual expenses. Receive a special Pin.

Banyan Guild Annual Dues - $ 2,500.00: Requires paid annual membership and is earmarked for funds to grow and sustain the organization with the objective of attaining 501(c)(3) status in the near future. Receive a Special Impact Name Tag.

Friendship Circle - $ 1,100.00: For a Scholarship Recipient or Sponsored Member

If you are sponsoring someone specific, please enter their name and email at the bottom of the form below. Otherwise, Impact will allocate funds to a potential member in need.

Total Amount

Impact Profile

First Name *

Last Name *

Home Address *

Community

Home City *

Home State *

Zip *

Personal Email *

Personal Cell *

Company

Job Title

Industry

Company Address

Company City

Company State

Company Zip

Company Phone

Company Email

Preferred Phone Number *

Personal Company

Preferred Email Address *

Personal Company

Birth Date (Month and Day)

I was referred by

I would like my name to appear as *

Only enter this information if you are sponsoring a specific member and selected "Friendship Circle" above.

Sponsored Member Name

Florida SB 700: By making this donation, I certify that I am not a citizen, resident, or entity of the People’s Republic of China, Russian Federation, Islamic Republic of Iran, Democratic People’s Republic of Korea, Republic of Cuba, Venezuelan regime of Nicolás Maduro, or Syrian Arab Republic, nor am I acting on behalf of or controlled by any such government, entity, or individual. I further certify that this donation is not made on behalf of any foreign source of concern as defined by Florida law.

Donor Attestation *

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Credit Card

Card Type

Card Number

Security Code

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

THE TOWN OF PALM BEACH UNITED WAY MEETS ALL REQUIREMENTS SPECIFIED BY THE FLORIDA SOLICITATION OF CONTRIBUTIONS ACT. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL FREE WITHIN THE STATE (1-800-435-7352). REGISTRATION DOES NOT IMPLY ENDORESEMENT, APPROVAL OR RECOMMENDATIONS BY THE STATE. FLORIDA REGISTRATION NUMBER 710843, FEDERAL ID NUMBER 59-063-7885. THE TOWN OF PALM BEACH UNITED WAY RECEIVES 100% OF EACH CONTRIBUTION. THIS INFORMATION WILL BE USED ONLY BY THE TOWN OF PALM BEACH UNITED WAY AND WILL NOT BE DISCLOSED TO OTHER PARTIES.