Miracle Maker Leadership Council (“MMLC”) - JOIN, RENEW, DONATE

Please complete this form to join the MMLC, renew your 3-year annual pledge, and/or make an online donation. Thank you for your generosity and leadership! You do not have to pay via credit card; please see below for information on the various ways to make a donation besides online.
* required information
Miracle Maker Leadership Council (“MMLC”) - JOIN, RENEW, DONATE 

MMLC Member Information
First Name:*
Last Name:*
Job Title:*
Company Name:*
Email:*
Phone:*
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
If you would like to make a donation via credit, please enter below.
$0.00 MMLC Membership

Donation Amount
Please enter $0 if you do not want to pay via credit card today, and note the payment method you plan to use below. You are welcome to make a partial or full payment today.
Amount:$

Additional Information
Select One:* New: I am joining the Miracle Maker Leadership Council. I commit to donating annually for 3 consecutive years the amount required for entry into the major donor circle I select. I consent to allow my name, corporate title, company, as written, to be used in print and electronically for recognition purposes.
Renewal: I have fulfilled my 3-year commitment and am making a new 3-year pledge. I commit to donating annually for 3 consecutive years the amount required for entry into the major donor circle I select. I consent to allow my name, corporate title, company, as written, to be used in print and electronically for recognition purposes.
Current: I am a current Member and am making an online donation toward my annual pledge.
Select Your Major Donor Circle:* Founder’s Circle - $10,000+ / year
Chairman’s Circle - $5,000 - $9,999 / year
President’s Circle - $3,000 - $4,999 / year
Leadership Circle - $1,000 - $2,999 / year
Leadership Circle - $500 / year (for Young Professionals age 21-39)
How will you be completing your pledge? (Check all that apply, you CAN donate through multiple methods. Check MMLC FAQ for info):* Check
Company Match
Donor Advised Fund
Online
Payroll Deduction
Stock
United Way
Other
Other? Please Specify:
Who referred you?:*