United Way Pledge Form | United Way of Santa Cruz County

United Way Pledge Form

Thank you for your interest in making a lasting difference with your contribution to United Way of Santa Cruz County. We are currently taking workplace pledges that will be a part of your payroll deduction starting January, 2015. Should you have any questions regarding your workplace campaign, please contact your United Way Employee Campaign Manager (name of Contact) at (phone number and email address).

First Name

Last Name

M.I.

Email Address

Address

Home Phone

Cell Phone

Work Phone

I wish to make an anonymous donation

I will invest in My United Way Community Investment Fund

I want to contribute

Every pay period

I wish to make a direct gift

My Total Gift Is...

Invest in United Way's Community Impact Areas As Follows

Investment Amount

Go for Health

Jovenes SANOS

Smart Solutions to Homeless

Youth Violence Prevention

Nonprofit 501(c)(3) Organization Name

Tax ID

Address

Please do not release my information to my restricted agency

Leadership Giving Circle

Emerging Leaders

Loyal Contributor

Woman in Philanthropy

Questions or Comments?

CAPTCHA

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.