Pledge Card - YWCA | United Way of Rock River Valley

Workplace Pledge Card -YWCA

Prefix

First

Middle Initial

Last

Preferred Email

This Email is:

Personal

Work

Preferred Phone

This Phone is:

Personal

Work

Date of Birth

I'm Retiring (Month/Year)

I wish to remain anonymous

Yes

Please tell us what name(s) to use when we thank you in recognition materials (Ex. John & Jane Smith)

Home Address

City

State

ZIP Code

My Investment

Preferred Donation Method

Payroll Deduction

Check

Credit Card

Check Donation

Amount of Check $

Make checks payable to United Way of the Rock River Valley. Please give the check to your Campaign Coordinator within 24 hours of this pledge.

Credit Card Donation

Amount of your One Time Donation $

After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!

Total Annual Contribution

TOTAL: $0

Donation Details

OPTIONAL You can choose your preferred donation area(s)

Invest my donation where it is needed most

Literacy

Community Impact

Please designate my investment to a different United Way or the Winnebago County human service 501(c)(3) organization

• Designations must be a minimum of $100. • A designation fee of 5% will be applied. • If the designation agency is not easily identified by the information provided, is not a registered 501(c)(3), does not certify as Patriot Act compliant, is no longer in operation, does not meet the minimum requirement, and/or does not cash any checks within one year, your gift will go to where it is needed most in our local community.

Amount per Year to Move the Middle $

Amount per Year to Literacy $

Amount per Year to Community Impact $

501c3 Organization (Other United Way or Agency)

Designations must be a minimum of $250.
A designation fee of 5% will be applied.
If the designation agency is not easily identified by the information provided, is not a registered 501(c)(3), does not certify as Patriot Act compliant, is no longer in operation, does not meet the minimum requirement, and/or does not cash any checks within one year, your gift will go to where it is needed most in our local community.

Name of Organization

Federal Tax ID#

Street Address

City

State

Zip Code

Organization Phone Number

Amount of Donation $

Agreement

My signature below, confirms my pledge as stated above.

Signature

Security Question: What color is the sky?

Pledge Card - YWCA

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