https://www.unitedwaysc.org/ en https://www.unitedwaysc.org/Lookout <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">LOOKOUT Santa Cruz Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:40:10+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:40pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1953" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1954" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-lookout-santa-cruz-form webform-submission-pledge-card-lookout-santa-cruz-add-form webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-form webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form" accept-charset="UTF-8"> <div id="edit-markup" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - Lookout Santa Cruz</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note-">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note-" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-5" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10" type="radio" id="edit-contribution-amount-per-pay-period-radios-10" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20" type="radio" id="edit-contribution-amount-per-pay-period-radios-20" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25" type="radio" id="edit-contribution-amount-per-pay-period-radios-25" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50" type="radio" id="edit-contribution-amount-per-pay-period-radios-50" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-" type="radio" id="edit-contribution-amount-per-pay-period-radios-other-" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other-"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1" aria-describedby="edit-number-of-pay-periods-for-donation--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12" aria-describedby="edit-number-of-pay-periods-for-donation--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one">Select One</label> <div id="edit-select-one" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation" type="radio" id="edit-select-one-one-time-donation" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation" type="radio" id="edit-select-one-monthly-recurring-donation" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc">Amount of Monthly Recurring</label> <div id="edit-monthly-cc" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60" type="radio" id="edit-monthly-cc-60" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120" type="radio" id="edit-monthly-cc-120" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300" type="radio" id="edit-monthly-cc-300" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600" type="radio" id="edit-monthly-cc-600" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200" type="radio" id="edit-monthly-cc-1200" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000" type="radio" id="edit-monthly-cc-3000" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options">Designation Options</label> <div id="edit-designation-options" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--description" type="checkbox" id="edit-designation-options-specific-agency" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency-">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency-" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--description" type="number" id="edit-amount-to-agency-1" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--description" type="number" id="edit-amount-to-agency-2" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--description" type="number" id="edit-amount-to-agency-3" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--description" type="number" id="edit-amount-to-agency-4" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply">Mark all that apply</label> <div id="edit-mark-all-that-apply" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19930" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="hkXMsQCdTxqSnSFFYKMA1TANrV-9TVH_oORhX8Qei9E" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit" type="submit" id="edit-actions-01-submit" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit" type="submit" id="edit-actions-submit" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-pbv7bng8wtrnqccukvqdg-fxfe83q58n2axklj65fc0" type="hidden" name="form_build_id" value="form-pBV7Bng8WTrNqccukVQDG-fXfE83q58n2AXklJ65FC0" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-lookout-santa-cruz-paragraph-1954-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_lookout_santa_cruz_paragraph_1954_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:40:10 +0000 sysop 1773 at https://www.unitedwaysc.org https://www.unitedwaysc.org/comcast <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Comcast Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:39:40+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:39pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1951" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1952" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-comcast-form webform-submission-pledge-card-comcast-add-form webform-submission-pledge-card-comcast-paragraph-1952-form webform-submission-pledge-card-comcast-paragraph-1952-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-comcast-paragraph-1952-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-comcast-paragraph-1952-add-form" accept-charset="UTF-8"> <div id="edit-markup--2" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - Comcast</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--2--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--2">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--2" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--2" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--2" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--2">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--2" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--2" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--2" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--2">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--2" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--2--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--2" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--2" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--2" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--2" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--2" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--2" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--2" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--2" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--2" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--2" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--2">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--2" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--2" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--2" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--2" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--2" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--2" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-2" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--2" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--2"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-2" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--2" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--2"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-2" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--2" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--2"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-2" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--2" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--2"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---2">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---2" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--2"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--2"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--2" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--2" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--2"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--2" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--2"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--2" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--2"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--2" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--2"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--2" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--2"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-2" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---2" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---2"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--2">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--2" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--2">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--2" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-2" aria-describedby="edit-number-of-pay-periods-for-donation--2--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--2" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--2"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-2" aria-describedby="edit-number-of-pay-periods-for-donation--2--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--2" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--2"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--2--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--2"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--2">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--2" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--2" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--2"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--2">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--2" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--2" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--2"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--2">Select One</label> <div id="edit-select-one--2" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-2" type="radio" id="edit-select-one-one-time-donation--2" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--2"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-2" type="radio" id="edit-select-one-monthly-recurring-donation--2" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--2"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--2">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--2" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--2">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--2" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-2" type="radio" id="edit-monthly-cc-60--2" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--2"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-2" type="radio" id="edit-monthly-cc-120--2" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--2"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-2" type="radio" id="edit-monthly-cc-300--2" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--2"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-2" type="radio" id="edit-monthly-cc-600--2" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--2"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-2" type="radio" id="edit-monthly-cc-1200--2" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--2"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-2" type="radio" id="edit-monthly-cc-3000--2" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--2"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--2"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--2"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--2" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--2"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--2">Designation Options</label> <div id="edit-designation-options--2" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--2--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--2" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--2"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--2--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--2--description" type="checkbox" id="edit-designation-options-specific-agency--2" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--2"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--2--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--2--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--2"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--2"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---2">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---2" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--2">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--2--description" type="number" id="edit-amount-to-agency-1--2" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--2--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--2"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--2">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--2" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--2">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--2--description" type="number" id="edit-amount-to-agency-2--2" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--2--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--2"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--2">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--2" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--2">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--2--description" type="number" id="edit-amount-to-agency-3--2" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--2--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--2"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--2">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--2" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--2">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--2--description" type="number" id="edit-amount-to-agency-4--2" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--2--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--2--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--2">Mark all that apply</label> <div id="edit-mark-all-that-apply--2" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--2" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--2"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--2" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--2"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--2" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--2"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--2"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--2" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--2" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--2--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--2--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19931" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="n8tROGmBV7-s18eea2gsKoKrbMyrSD9WjlitBVad_OU" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--2"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-2" type="submit" id="edit-actions-01-submit--2" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-comcast-paragraph-1952-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--3"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-2" type="submit" id="edit-actions-submit--2" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-egrak6fnf0ggmhmzfnt3nvpbdc27n2o60egvr8kpwxi" type="hidden" name="form_build_id" value="form-EGraK6fNF0GgmHmZfnt3nVpBDc27n2O60eGvr8KpwxI" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-comcast-paragraph-1952-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_comcast_paragraph_1952_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--2">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--2" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:39:40 +0000 sysop 1772 at https://www.unitedwaysc.org https://www.unitedwaysc.org/UPS <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">UPS Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:39:09+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:39pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1949" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1950" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-ups-form webform-submission-pledge-card-ups-add-form webform-submission-pledge-card-ups-paragraph-1950-form webform-submission-pledge-card-ups-paragraph-1950-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-ups-paragraph-1950-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-ups-paragraph-1950-add-form" accept-charset="UTF-8"> <div id="edit-markup--3" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - UPS</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--3--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--3">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--3" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--3" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--3" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--3">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--3" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--3" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--3" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--3">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--3" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--3--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--3" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--3" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--3" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--3" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--3" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--3" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--3" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--3" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--3" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--3" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--3">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--3" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--3" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--3" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--3" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--3" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--3" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-3" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--3" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--3"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-3" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--3" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--3"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-3" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--3" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--3"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-3" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--3" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--3"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---3">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---3" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--3"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--3"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--3" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--3" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--3"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--3" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--3"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--3" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--3"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--3" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--3"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--3" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--3"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-3" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---3" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---3"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--3">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--3" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--3">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--3" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-3" aria-describedby="edit-number-of-pay-periods-for-donation--3--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--3" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--3"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-3" aria-describedby="edit-number-of-pay-periods-for-donation--3--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--3" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--3"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--3--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--3"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--3">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--3" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--3" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--3"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--3">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--3" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--3" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--3"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--3">Select One</label> <div id="edit-select-one--3" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-3" type="radio" id="edit-select-one-one-time-donation--3" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--3"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-3" type="radio" id="edit-select-one-monthly-recurring-donation--3" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--3"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--3">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--3" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--3">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--3" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-3" type="radio" id="edit-monthly-cc-60--3" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--3"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-3" type="radio" id="edit-monthly-cc-120--3" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--3"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-3" type="radio" id="edit-monthly-cc-300--3" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--3"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-3" type="radio" id="edit-monthly-cc-600--3" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--3"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-3" type="radio" id="edit-monthly-cc-1200--3" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--3"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-3" type="radio" id="edit-monthly-cc-3000--3" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--3"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--3"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--3"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--3" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--3"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--3">Designation Options</label> <div id="edit-designation-options--3" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--3--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--3" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--3"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--3--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--3--description" type="checkbox" id="edit-designation-options-specific-agency--3" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--3"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--3--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--3--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--3"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--3"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---3">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---3" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--3">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--3--description" type="number" id="edit-amount-to-agency-1--3" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--3--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--3"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--3">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--3" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--3">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--3--description" type="number" id="edit-amount-to-agency-2--3" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--3--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--3"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--3">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--3" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--3">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--3--description" type="number" id="edit-amount-to-agency-3--3" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--3--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--3"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--3">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--3" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--3">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--3--description" type="number" id="edit-amount-to-agency-4--3" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--3--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--3--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--3">Mark all that apply</label> <div id="edit-mark-all-that-apply--3" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--3" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--3"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--3" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--3"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--3" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--3"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--3"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--3" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--3" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--3--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--3--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19932" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="J0gn95HIcjql8EKht4Dhy4QcVFpVGLddVvCnJXogTso" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--3"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-3" type="submit" id="edit-actions-01-submit--3" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-ups-paragraph-1950-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--5"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-3" type="submit" id="edit-actions-submit--3" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-n6rdpdbboqz3wgp9pmxipcm309ghoz1eiswk07-vspm" type="hidden" name="form_build_id" value="form-n6RDPDbboqz3WGp9PmXIPcm309ghOZ1Eiswk07_vSPM" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-ups-paragraph-1950-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_ups_paragraph_1950_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--3">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--3" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:39:09 +0000 sysop 1771 at https://www.unitedwaysc.org https://www.unitedwaysc.org/comerica <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Comerica Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:34:19+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:34pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1947" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1948" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-comerica-form webform-submission-pledge-card-comerica-add-form webform-submission-pledge-card-comerica-paragraph-1948-form webform-submission-pledge-card-comerica-paragraph-1948-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-comerica-paragraph-1948-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-comerica-paragraph-1948-add-form" accept-charset="UTF-8"> <div id="edit-markup--4" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - Comerica</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--4--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--4">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--4" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--4" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--4" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--4">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--4" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--4" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--4" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--4">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--4" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--4--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--4" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--4" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--4" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--4" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--4" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--4" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--4" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--4" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--4" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--4" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--4">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--4" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--4" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--4" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--4" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--4" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--4" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-4" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--4" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--4"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-4" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--4" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--4"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-4" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--4" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--4"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-4" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--4" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--4"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---4">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---4" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--4"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--4"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--4" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--4" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--4"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--4" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--4"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--4" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--4"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--4" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--4"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--4" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--4"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-4" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---4" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---4"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--4">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--4" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--4">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--4" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-4" aria-describedby="edit-number-of-pay-periods-for-donation--4--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--4" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--4"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-4" aria-describedby="edit-number-of-pay-periods-for-donation--4--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--4" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--4"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--4--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--4"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--4">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--4" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--4" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--4"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--4">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--4" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--4" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--4"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--4">Select One</label> <div id="edit-select-one--4" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-4" type="radio" id="edit-select-one-one-time-donation--4" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--4"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-4" type="radio" id="edit-select-one-monthly-recurring-donation--4" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--4"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--4">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--4" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--4">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--4" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-4" type="radio" id="edit-monthly-cc-60--4" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--4"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-4" type="radio" id="edit-monthly-cc-120--4" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--4"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-4" type="radio" id="edit-monthly-cc-300--4" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--4"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-4" type="radio" id="edit-monthly-cc-600--4" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--4"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-4" type="radio" id="edit-monthly-cc-1200--4" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--4"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-4" type="radio" id="edit-monthly-cc-3000--4" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--4"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--4"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--4"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--4" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--4"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--4">Designation Options</label> <div id="edit-designation-options--4" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--4--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--4" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--4"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--4--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--4--description" type="checkbox" id="edit-designation-options-specific-agency--4" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--4"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--4--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--4--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--4"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--4"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---4">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---4" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--4">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--4--description" type="number" id="edit-amount-to-agency-1--4" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--4--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--4"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--4">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--4" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--4">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--4--description" type="number" id="edit-amount-to-agency-2--4" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--4--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--4"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--4">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--4" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--4">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--4--description" type="number" id="edit-amount-to-agency-3--4" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--4--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--4"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--4">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--4" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--4">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--4--description" type="number" id="edit-amount-to-agency-4--4" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--4--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--4--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--4">Mark all that apply</label> <div id="edit-mark-all-that-apply--4" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--4" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--4"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--4" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--4"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--4" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--4"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--4"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--4" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--4" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--4--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--4--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19933" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="lCfV33N6rkI_qopZudkRM8FIBk8W5GalwvDlXUPQgfE" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--4"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-4" type="submit" id="edit-actions-01-submit--4" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-comerica-paragraph-1948-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--7"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-4" type="submit" id="edit-actions-submit--4" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-lxox9xkqomqktbjestimagwrcq5ob9shqw3zmgbkmjw" type="hidden" name="form_build_id" value="form-lxox9xKQOMQkTbJEstImAGwRCQ5OB9shqw3ZMgbKmJw" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-comerica-paragraph-1948-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_comerica_paragraph_1948_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--4">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--4" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:34:19 +0000 sysop 1770 at https://www.unitedwaysc.org https://www.unitedwaysc.org/dominican-hospital <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Dominican Hospital Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:30:00+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:30pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1945" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1946" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-dominican-hospital-form webform-submission-pledge-card-dominican-hospital-add-form webform-submission-pledge-card-dominican-hospital-paragraph-1946-form webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form" accept-charset="UTF-8"> <div id="edit-markup--5" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - Dominican Hospital</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--5--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--5">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--5" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--5" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--5" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--5">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--5" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--5" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--5" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--5">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--5" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--5--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--5" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--5" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--5" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--5" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--5" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--5" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--5" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--5" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--5" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--5" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--5">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--5" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--5" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--5" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--5" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--5" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--5" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-5" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--5" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--5"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-5" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--5" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--5"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-5" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--5" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--5"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-5" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--5" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--5"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---5">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---5" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--5"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--5"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--5" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--5" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--5"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--5" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--5"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--5" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--5"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--5" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--5"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--5" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--5"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-5" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---5" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---5"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--5">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--5" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--5">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--5" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-5" aria-describedby="edit-number-of-pay-periods-for-donation--5--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--5" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--5"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-5" aria-describedby="edit-number-of-pay-periods-for-donation--5--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--5" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--5"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--5--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--5"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--5">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--5" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--5" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--5"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--5">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--5" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--5" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--5"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--5">Select One</label> <div id="edit-select-one--5" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-5" type="radio" id="edit-select-one-one-time-donation--5" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--5"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-5" type="radio" id="edit-select-one-monthly-recurring-donation--5" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--5"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--5">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--5" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--5">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--5" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-5" type="radio" id="edit-monthly-cc-60--5" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--5"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-5" type="radio" id="edit-monthly-cc-120--5" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--5"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-5" type="radio" id="edit-monthly-cc-300--5" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--5"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-5" type="radio" id="edit-monthly-cc-600--5" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--5"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-5" type="radio" id="edit-monthly-cc-1200--5" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--5"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-5" type="radio" id="edit-monthly-cc-3000--5" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--5"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--5"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--5"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--5" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--5"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--5">Designation Options</label> <div id="edit-designation-options--5" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--5--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--5" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--5"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--5--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--5--description" type="checkbox" id="edit-designation-options-specific-agency--5" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--5"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--5--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--5--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--5"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--5"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---5">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---5" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--5">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--5--description" type="number" id="edit-amount-to-agency-1--5" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--5--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--5"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--5">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--5" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--5">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--5--description" type="number" id="edit-amount-to-agency-2--5" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--5--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--5"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--5">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--5" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--5">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--5--description" type="number" id="edit-amount-to-agency-3--5" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--5--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--5"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--5">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--5" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--5">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--5--description" type="number" id="edit-amount-to-agency-4--5" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--5--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--5--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--5">Mark all that apply</label> <div id="edit-mark-all-that-apply--5" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--5" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--5"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--5" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--5"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--5" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--5"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--5"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--5" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--5" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--5--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--5--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19934" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="913zCxWEgccbH6HjRpaBz1sXrBCQodtayxPC1eqve6E" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--5"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-5" type="submit" id="edit-actions-01-submit--5" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--9"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-5" type="submit" id="edit-actions-submit--5" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-rbxk8d4bl670ae-onsctjrdgdckqdpyepbponiy8okc" type="hidden" name="form_build_id" value="form-rbxK8d4bL670AE-ONsCTJrdgDCKQDpyEpbpoNiY8Okc" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-dominican-hospital-paragraph-1946-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_dominican_hospital_paragraph_1946_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--5">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--5" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:30:00 +0000 sysop 1769 at https://www.unitedwaysc.org https://www.unitedwaysc.org/city-capitola <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">City of Capitola Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:27:38+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:27pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1943" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h2>UNITED WE THRIVE</h2> <p>At United Way Santa Cruz County, our mission is to <strong>ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, families are financially stable, and everyone has the opportunity to thrive.</strong><br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> <li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> <p>Additionally, you can amplify your impact by joining one of our <strong>Affinity Giving Circles</strong>:</p> <ul><li><a href="https://www.unitedwaysc.org/wip" target="_blank">Women in Philanthropy</a> (WIP) – A network of women leaders dedicated to creating opportunity for youth in Santa Cruz County. Join by giving $1,000/year.</li> <li><a href="https://www.unitedwaysc.org/emerging-leaders-circle" target="_blank">Emerging Leaders Circle</a> (ELC)  – A space for early to mid-career professionals to connect, serve, and lead through volunteerism and community action. <em>Join by giving $10/month or $100/year.</em></li> </ul><p>Your donation—no matter the amount—makes a real difference.</p> <p>Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1944" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-city-of-capitola-form webform-submission-pledge-card-city-of-capitola-add-form webform-submission-pledge-card-city-of-capitola-paragraph-1944-form webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form" accept-charset="UTF-8"> <div id="edit-markup--6" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - City of Capitola</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--6--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--6">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--6" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--6" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--6" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--6">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--6" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--6" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--6" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--6">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--6" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--6--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--6" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--6" name="your_contact_information[company]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--6" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--6" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--6" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--6" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--6" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--6" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--6" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--6" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--6">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--6" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--6" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--6" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--6" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--6" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--6" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-6" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--6" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--6"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-6" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--6" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--6"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-6" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--6" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--6"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-6" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--6" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--6"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---6">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---6" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--6"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--6"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--6" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--6" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--6"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--6" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--6"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--6" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--6"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--6" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--6"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--6" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--6"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-6" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---6" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---6"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--6">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--6" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--6">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--6" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-6" aria-describedby="edit-number-of-pay-periods-for-donation--6--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--6" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--6"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-6" aria-describedby="edit-number-of-pay-periods-for-donation--6--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--6" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--6"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--6--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--6"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--6">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--6" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--6" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--6"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--6">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--6" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--6" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--6"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--6">Select One</label> <div id="edit-select-one--6" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-6" type="radio" id="edit-select-one-one-time-donation--6" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--6"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-6" type="radio" id="edit-select-one-monthly-recurring-donation--6" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--6"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--6">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--6" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--6">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--6" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-6" type="radio" id="edit-monthly-cc-60--6" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--6"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-6" type="radio" id="edit-monthly-cc-120--6" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--6"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-6" type="radio" id="edit-monthly-cc-300--6" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--6"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-6" type="radio" id="edit-monthly-cc-600--6" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--6"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-6" type="radio" id="edit-monthly-cc-1200--6" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--6"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-6" type="radio" id="edit-monthly-cc-3000--6" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--6"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--6"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--6"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--6" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--6"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--6">Designation Options</label> <div id="edit-designation-options--6" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--6--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--6" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--6"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--6--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--6--description" type="checkbox" id="edit-designation-options-specific-agency--6" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--6"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--6--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--6--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--6"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--6"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---6">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---6" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--6">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--6--description" type="number" id="edit-amount-to-agency-1--6" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--6--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--6"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--6">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--6" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--6">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--6--description" type="number" id="edit-amount-to-agency-2--6" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--6--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--6"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--6">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--6" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--6">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--6--description" type="number" id="edit-amount-to-agency-3--6" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--6--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--6"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--6">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--6" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--6">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--6--description" type="number" id="edit-amount-to-agency-4--6" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--6--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--6--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--6">Mark all that apply</label> <div id="edit-mark-all-that-apply--6" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--6" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--6"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--6" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--6"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--6" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--6"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--6"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--6" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--6" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--6--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--6--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19935" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="-GJUXYwfCYvqiRt72lMTdX1sTLjBoBCPPNrzZeHJoTI" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--6"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-6" type="submit" id="edit-actions-01-submit--6" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--11"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-6" type="submit" id="edit-actions-submit--6" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-zxdwk4qem43ikepqyglsjaq4ef9dgusl9vsezosjwzc" type="hidden" name="form_build_id" value="form-ZXDwk4QEM43IKEPqYGlSjAq4EF9dGusL9VSEZoSJwzc" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-city-of-capitola-paragraph-1944-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_city_of_capitola_paragraph_1944_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--6">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--6" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:27:38 +0000 sysop 1768 at https://www.unitedwaysc.org https://www.unitedwaysc.org/central-coast <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Central California Alliance for Health Campaign</span> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/users/sysop" typeof="schema:Person" property="schema:name" datatype="">sysop</span></span> <span property="schema:dateCreated" content="2025-09-06T02:23:42+00:00" class="field field--name-created field--type-created field--label-hidden">Fri, 09/05/2025 - 7:23pm</span> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1941" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p><img src="/sites/unitedwaysc/files/UWSCC%202025%20OCT1.jpg" width="956" class="align-center" /></p><p>At United Way Santa Cruz County, our mission is to ignite our community to give, advocate, and volunteer so that all youth succeed in school and life, our residents are healthy, and our families are financially independent. <br />Through our two core initiatives—<strong>United4Youth</strong> and <strong>United4Community</strong>—we tackle the most pressing needs in our region:</p> <ul><li><strong>United4Youth</strong> invests in programs that support youth mental health, civic engagement, leadership development, and safer spaces for youth across Santa Cruz County. Programs include: <ul><li><a href="https://www.unitedwaysc.org/jovenes-sanos" target="_blank">Jóvenes Sanos</a>  </li> <li><a href="http://www.sccyan.org/" target="_blank">Youth Action Network</a></li> <li><a href="http://www.sccyan.org/yan--ucsc-research.html" target="_blank">YPAR/Youth Participatory Action Research</a></li> </ul></li> </ul><p><img src="/sites/unitedwaysc/files/4.jpg" width="757" class="align-center" /></p><p> </p> <ul><li><strong>United4Community</strong> ensures access to essential resources such as food, housing, healthcare, and emergency response through services like: <ul><li><a href="https://211santacruzcounty.org/" target="_blank">211 Santa Cruz County</a> – a 24/7 information and referral service connecting people to local resources, especially during times of crisis like wildfires, floods, and pandemics.</li> <li>Free Tax Preparation Services</li> <li>The development of our <strong>Closed Loop Referral System</strong>, helping families access coordinated care.</li> </ul></li> </ul><p><img src="/sites/unitedwaysc/files/9.jpg" width="757" class="align-center" /></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-columns paragraph--view-mode--default" id="vbp-1968" > <div class="row"> <div class="col-12"> <div class="row"> <div class="col-lg-6" > <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1966" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p>When you support our workplace giving, you’re helping create lasting change right here at home. You can give a one-time donation or set up recurring contributions directly through your payroll.</p> </div> </div> </div> </div> </div> <div class="col-lg-6" > <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1967" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><div style="display:flex;justify-content:center;"> <iframe style="aspect-ratio:16 / 9;width:100% !important;" src="https://www.youtube.com/embed/lGim0X0rw4o?si=re_4G0_jg0unXPSe" title="YouTube video player" frameborder="0" allow="accelerometer; autoplay; clipboard-write; encrypted-media; gyroscope; picture-in-picture; web-share" referrerpolicy="strict-origin-when-cross-origin" allowfullscreen=""></iframe></div> </div> </div> </div> </div> </div></div> </div> </div> </div> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-1969" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><p>Your donation—no matter the amount—makes a real difference. Join us in building a stronger, more connected Santa Cruz County</p> <h2>Options to Donate</h2> <ol><li>Use our electronic pledge card below</li> <li>Download our paper form, complete it and email it to <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a> - <a href="https://www.unitedwaysc.org/sites/unitedwaysc/files/UWSCCFillablePledgeForm2025V2.pdf" target="_blank">Download Pledge Form Here</a></li> </ol><p>Should you have any questions regarding the United Way Campaign, please contact <a href="mailto:campaign@unitedwaysc.org">campaign@unitedwaysc.org</a></p> </div> </div> </div> </div> <div class="paragraph paragraph--type--bp-webform paragraph--view-mode--default" id="vbp-1942" > <div class="row"> <div class="col-12"> <div class="field field--name-bp-webform-field field--type-webform field--label-hidden field__item"> <form class="webform-submission-form webform-submission-add-form webform-submission-pledge-card-central-coast-allian-form webform-submission-pledge-card-central-coast-allian-add-form webform-submission-pledge-card-central-coast-allian-paragraph-1942-form webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form" action="/taxonomy/term/35/feed" method="post" id="webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form" accept-charset="UTF-8"> <div id="edit-markup--7" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup form-item-markup form-no-label mb-3"> <h1>Workplace Giving Card - Central California Alliance for Health</h1> </div> <fieldset data-drupal-selector="edit-your-name" id="edit-your-name--7--wrapper" class="webform-name--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-name webform-type-webform-name js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Name</span> </legend> <div class="fieldset-wrapper"> <div class="webform-name"> <div class="webform-flexbox"> <div class="webform-flex webform-flex--2 webform-name__title"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-title form-item-your-name-title mb-3"> <label for="edit-your-name-title--7">Title</label> <input data-drupal-selector="edit-your-name-title" type="text" id="edit-your-name-title--7" name="your_name[title]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__first"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-first form-item-your-name-first mb-3"> <label for="edit-your-name-first--7" class="js-form-required form-required">First</label> <input data-drupal-selector="edit-your-name-first" type="text" id="edit-your-name-first--7" name="your_name[first]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--2 webform-name__middle"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-middle form-item-your-name-middle mb-3"> <label for="edit-your-name-middle--7">Middle</label> <input data-drupal-selector="edit-your-name-middle" type="text" id="edit-your-name-middle--7" name="your_name[middle]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> <div class="webform-flex webform-flex--3 webform-name__last"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-last form-item-your-name-last mb-3"> <label for="edit-your-name-last--7" class="js-form-required form-required">Last</label> <input data-drupal-selector="edit-your-name-last" type="text" id="edit-your-name-last--7" name="your_name[last]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-name__suffix"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-name-suffix form-item-your-name-suffix mb-3"> <label for="edit-your-name-suffix--7">Suffix</label> <input data-drupal-selector="edit-your-name-suffix" type="text" id="edit-your-name-suffix--7" name="your_name[suffix]" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-your-contact-information" id="edit-your-contact-information--7--wrapper" class="webform-contact--wrapper fieldgroup form-composite webform-composite-hidden-title required js-webform-type-webform-contact webform-type-webform-contact js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="visually-hidden fieldset-legend js-form-required form-required">Your Contact Information</span> </legend> <div class="fieldset-wrapper"> <div class="webform-contact"> <div class="webform-flexbox webform-contact__row-1"> <div class="webform-flex webform-flex--1 webform-address__company"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-company form-item-your-contact-information-company mb-3"> <label for="edit-your-contact-information-company--7" class="js-form-required form-required">Company</label> <input data-drupal-selector="edit-your-contact-information-company" type="text" id="edit-your-contact-information-company--7" name="your_contact_information[company]" value="" size="60" maxlength="255" placeholder="Central California Alliance for Health" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-2"> <div class="webform-flex webform-flex--1 webform-address__email"><div class="webform-flex--container"> <div class="js-form-item js-form-type-email form-type-email js-form-item-your-contact-information-email form-item-your-contact-information-email mb-3"> <label for="edit-your-contact-information-email--7" class="js-form-required form-required">Email</label> <input data-drupal-selector="edit-your-contact-information-email" type="email" id="edit-your-contact-information-email--7" name="your_contact_information[email]" value="" size="60" maxlength="254" class="form-email required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__phone"><div class="webform-flex--container"> <div class="js-form-item js-form-type-tel form-type-tel js-form-item-your-contact-information-phone form-item-your-contact-information-phone mb-3"> <label for="edit-your-contact-information-phone--7" class="js-form-required form-required">Phone</label> <input data-drupal-selector="edit-your-contact-information-phone" type="tel" id="edit-your-contact-information-phone--7" name="your_contact_information[phone]" value="" size="30" maxlength="128" class="form-tel required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-3"> <div class="webform-flex webform-flex--1 webform-address__address"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-address form-item-your-contact-information-address mb-3"> <label for="edit-your-contact-information-address--7" class="js-form-required form-required">Address</label> <input data-drupal-selector="edit-your-contact-information-address" type="text" id="edit-your-contact-information-address--7" name="your_contact_information[address]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> <div class="webform-flexbox webform-contact__row-5"> <div class="webform-flex webform-flex--1 webform-address__city"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-city form-item-your-contact-information-city mb-3"> <label for="edit-your-contact-information-city--7" class="js-form-required form-required">City</label> <input data-drupal-selector="edit-your-contact-information-city" type="text" id="edit-your-contact-information-city--7" name="your_contact_information[city]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__province"><div class="webform-flex--container"> <div class="js-form-item js-form-type-select form-type-select js-form-item-your-contact-information-state-province form-item-your-contact-information-state-province mb-3"> <label for="edit-your-contact-information-state-province--7">State</label> <select data-drupal-selector="edit-your-contact-information-state-province" id="edit-your-contact-information-state-province--7" name="your_contact_information[state_province]" class="form-select"><option value="" selected="selected">- None -</option><option value="Alabama">Alabama</option><option value="Alaska">Alaska</option><option value="American Samoa">American Samoa</option><option value="Arizona">Arizona</option><option value="Arkansas">Arkansas</option><option value="Armed Forces (Canada, Europe, Africa, or Middle East)">Armed Forces (Canada, Europe, Africa, or Middle East)</option><option value="Armed Forces Americas">Armed Forces Americas</option><option value="Armed Forces Pacific">Armed Forces Pacific</option><option value="California">California</option><option value="Colorado">Colorado</option><option value="Connecticut">Connecticut</option><option value="Delaware">Delaware</option><option value="District of Columbia">District of Columbia</option><option value="Federated States of Micronesia">Federated States of Micronesia</option><option value="Florida">Florida</option><option value="Georgia">Georgia</option><option value="Guam">Guam</option><option value="Hawaii">Hawaii</option><option value="Idaho">Idaho</option><option value="Illinois">Illinois</option><option value="Indiana">Indiana</option><option value="Iowa">Iowa</option><option value="Kansas">Kansas</option><option value="Kentucky">Kentucky</option><option value="Louisiana">Louisiana</option><option value="Maine">Maine</option><option value="Marshall Islands">Marshall Islands</option><option value="Maryland">Maryland</option><option value="Massachusetts">Massachusetts</option><option value="Michigan">Michigan</option><option value="Minnesota">Minnesota</option><option value="Mississippi">Mississippi</option><option value="Missouri">Missouri</option><option value="Montana">Montana</option><option value="Nebraska">Nebraska</option><option value="Nevada">Nevada</option><option value="New Hampshire">New Hampshire</option><option value="New Jersey">New Jersey</option><option value="New Mexico">New Mexico</option><option value="New York">New York</option><option value="North Carolina">North Carolina</option><option value="North Dakota">North Dakota</option><option value="Northern Mariana Islands">Northern Mariana Islands</option><option value="Ohio">Ohio</option><option value="Oklahoma">Oklahoma</option><option value="Oregon">Oregon</option><option value="Palau">Palau</option><option value="Pennsylvania">Pennsylvania</option><option value="Puerto Rico">Puerto Rico</option><option value="Rhode Island">Rhode Island</option><option value="South Carolina">South Carolina</option><option value="South Dakota">South Dakota</option><option value="Tennessee">Tennessee</option><option value="Texas">Texas</option><option value="Utah">Utah</option><option value="Vermont">Vermont</option><option value="Virgin Islands">Virgin Islands</option><option value="Virginia">Virginia</option><option value="Washington">Washington</option><option value="West Virginia">West Virginia</option><option value="Wisconsin">Wisconsin</option><option value="Wyoming">Wyoming</option></select> </div> </div></div> <div class="webform-flex webform-flex--1 webform-address__postal-code"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-your-contact-information-postal-code form-item-your-contact-information-postal-code mb-3"> <label for="edit-your-contact-information-postal-code--7" class="js-form-required form-required">ZIP Code</label> <input data-drupal-selector="edit-your-contact-information-postal-code" type="text" id="edit-your-contact-information-postal-code--7" name="your_contact_information[postal_code]" value="" size="60" maxlength="255" class="required form-control" required="required" aria-required="true" /> </div> </div></div> </div> </div> </div> </fieldset> <fieldset data-drupal-selector="edit-donation-method" id="edit-donation-method--7" class="js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3"> <legend> <span class="fieldset-legend">Donation Method</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-preferred-donation-method form-item-preferred-donation-method mb-3"> <label for="edit-preferred-donation-method--7" class="js-form-required form-required">Preferred Donation Method</label> <div id="edit-preferred-donation-method--7" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction-7" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--7" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-payroll-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-payroll-deduction--7"> Payroll Deduction </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction-7" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--7" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-check-deduction" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-check-deduction--7"> Check </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation-7" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--7" name="preferred_donation_method" value="https://www.unitedwaysc.org/thank-you-your-cash-donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgthank-you-your-cash-donation--7"> Cash </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-preferred-donation-method form-item-preferred-donation-method"> <input data-drupal-selector="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc-7" type="radio" id="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--7" name="preferred_donation_method" value="https://www.unitedwaysc.org/pledge-cc" class="form-radio form-check-input"> <label class="form-check-label" for="edit-preferred-donation-method-httpswwwunitedwayscorgpledge-cc--7"> Credit/Debit Card </label> </div> </div> </div> <div class="js-form-item js-form-type-textarea form-type-textarea js-form-item-personal-note- form-item-personal-note- mb-3"> <label for="edit-personal-note---7">Personal Note: </label> <div class="form-textarea-wrapper"> <textarea data-drupal-selector="edit-personal-note-" id="edit-personal-note---7" name="personal_note_" rows="5" cols="60" class="form-textarea form-control resize-vertical"></textarea> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-payroll-deduction" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}}}" id="edit-payroll-deduction--7"> <legend> <span class="fieldset-legend">Payroll Deduction</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-radios-other webform-radios-other js-form-item js-form-type-webform-radios-other form-type-webform-radios-other js-form-item-contribution-amount-per-pay-period form-item-contribution-amount-per-pay-period mb-3" id="edit-contribution-amount-per-pay-period--7"> <label>Contribution Amount Per Pay Period</label> <div id="edit-contribution-amount-per-pay-period-radios--7" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-5-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-5--7" name="contribution_amount_per_pay_period[radios]" value="5" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-5--7"> $5 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-10-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-10--7" name="contribution_amount_per_pay_period[radios]" value="10" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-10--7"> $10 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-20-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-20--7" name="contribution_amount_per_pay_period[radios]" value="20" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-20--7"> $20 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-25-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-25--7" name="contribution_amount_per_pay_period[radios]" value="25" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-25--7"> $25 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-50-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-50--7" name="contribution_amount_per_pay_period[radios]" value="50" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-50--7"> $50 </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-contribution-amount-per-pay-period-radios form-item-contribution-amount-per-pay-period-radios"> <input data-drupal-selector="edit-contribution-amount-per-pay-period-radios-other-7" type="radio" id="edit-contribution-amount-per-pay-period-radios-other---7" name="contribution_amount_per_pay_period[radios]" value="_other_" class="form-radio form-check-input"> <label class="form-check-label" for="edit-contribution-amount-per-pay-period-radios-other---7"> Other… </label> </div> </div> <div class="js-webform-radios-other-input webform-radios-other-input webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-contribution-amount-per-pay-period-other form-item-contribution-amount-per-pay-period-other mb-3"> <label for="edit-contribution-amount-per-pay-period-other--7">Please enter the NUMBER only</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-contribution-amount-per-pay-period-other" type="number" id="edit-contribution-amount-per-pay-period-other--7" name="contribution_amount_per_pay_period[other]" value="" step="any" placeholder="" class="form-number form-control" /> </div> </div> </div> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation mb-3"> <label for="edit-number-of-pay-periods-for-donation--7">Number of Pay Periods for Donation</label> <div id="edit-number-of-pay-periods-for-donation--7" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-1-7" aria-describedby="edit-number-of-pay-periods-for-donation--7--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-1--7" name="number_of_pay_periods_for_donation" value="1" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-1--7"> One Time Gift </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-number-of-pay-periods-for-donation form-item-number-of-pay-periods-for-donation"> <input data-drupal-selector="edit-number-of-pay-periods-for-donation-12-7" aria-describedby="edit-number-of-pay-periods-for-donation--7--wrapper--description" type="radio" id="edit-number-of-pay-periods-for-donation-12--7" name="number_of_pay_periods_for_donation" value="12" class="form-radio form-check-input"> <label class="form-check-label" for="edit-number-of-pay-periods-for-donation-12--7"> Monthly Recurring </label> </div> </div> <small class="description text-muted"> <div id="edit-number-of-pay-periods-for-donation--7--description" class="webform-element-description"><strong>To cancel reoccuring please contact your HR Department</strong></div> </small> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-check-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}}}" id="edit-check-donation--7"> <legend> <span class="fieldset-legend">Check Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-ck form-item-amount-of-ck mb-3"> <label for="edit-amount-of-ck--7">Amount of Check</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-ck" type="number" id="edit-amount-of-ck--7" name="amount_of_ck" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-04--7" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-04 form-item-markup-04 form-no-label mb-3"> <strong>Make checks payable to United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-cash-donations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}}" id="edit-cash-donations--7"> <legend> <span class="fieldset-legend">Cash Donation</span> </legend> <div class="fieldset-wrapper"> <div class="webform-has-field-prefix js-form-item js-form-type-number form-type-number js-form-item-amount-of-cash-donation form-item-amount-of-cash-donation mb-3"> <label for="edit-amount-of-cash-donation--7">Amount of Cash</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-cash-donation" type="number" id="edit-amount-of-cash-donation--7" name="amount_of_cash_donation" value="" step="any" class="form-number form-control" /> </div> </div> <div id="edit-markup-05--7" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-05 form-item-markup-05 form-no-label mb-3"> <strong>Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.</strong> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-credit-debit-card-donation" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-credit-debit-card-donation--7"> <legend> <span class="fieldset-legend">Credit/Debit Card Donation</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-radios form-type-radios js-form-item-select-one form-item-select-one mb-3"> <label for="edit-select-one--7">Select One</label> <div id="edit-select-one--7" class="js-webform-radios webform-options-display-side-by-side radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-one-time-donation-7" type="radio" id="edit-select-one-one-time-donation--7" name="select_one" value="One Time Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-one-time-donation--7"> One Time Donation </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-select-one form-item-select-one"> <input data-drupal-selector="edit-select-one-monthly-recurring-donation-7" type="radio" id="edit-select-one-monthly-recurring-donation--7" name="select_one" value="Monthly Recurring Donation" class="form-radio form-check-input"> <label class="form-check-label" for="edit-select-one-monthly-recurring-donation--7"> Monthly Recurring Donation </label> </div> </div> </div> <div class="webform-has-field-prefix js-webform-states-hidden js-form-item js-form-type-number form-type-number js-form-item-amount-of-your-one-time-donation form-item-amount-of-your-one-time-donation mb-3"> <label for="edit-amount-of-your-one-time-donation--7">Amount of your One Time Donation</label> <div class="input-group"> <div class="input-group-prepend"> <span class="field-prefix input-group-text">$</span> </div> <input data-drupal-selector="edit-amount-of-your-one-time-donation" type="number" id="edit-amount-of-your-one-time-donation--7" name="amount_of_your_one_time_donation" value="" step="any" class="form-number form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;One Time Donation&quot;}}}" /> </div> </div> <div class="js-webform-states-hidden js-form-item js-form-type-radios form-type-radios js-form-item-monthly-cc form-item-monthly-cc mb-3" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;value&quot;:&quot;Monthly Recurring Donation&quot;}}}"> <label for="edit-monthly-cc--7">Amount of Monthly Recurring</label> <div id="edit-monthly-cc--7" class="js-webform-radios webform-options-display-three-columns radio"> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-60-7" type="radio" id="edit-monthly-cc-60--7" name="monthly_cc" value="60" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-60--7"> $5/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-120-7" type="radio" id="edit-monthly-cc-120--7" name="monthly_cc" value="120" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-120--7"> $10/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-300-7" type="radio" id="edit-monthly-cc-300--7" name="monthly_cc" value="300" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-300--7"> $25/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-600-7" type="radio" id="edit-monthly-cc-600--7" name="monthly_cc" value="600" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-600--7"> $50/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-1200-7" type="radio" id="edit-monthly-cc-1200--7" name="monthly_cc" value="1200" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-1200--7"> $100/month </label> </div> <div class="js-form-item js-form-type-radio radio form-check js-form-item-monthly-cc form-item-monthly-cc"> <input data-drupal-selector="edit-monthly-cc-3000-7" type="radio" id="edit-monthly-cc-3000--7" name="monthly_cc" value="3000" class="form-radio form-check-input"> <label class="form-check-label" for="edit-monthly-cc-3000--7"> $250/month </label> </div> </div> </div> <div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022select_one\u0022]&quot;:{&quot;checked&quot;:true}}}"> <div class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-02 form-item-markup-02 form-no-label mb-3" id="edit-markup-02--7"> <p><strong>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. And please consider covering the 3% online credit card processing fee to provide the greatest benefit. Thank you!</strong></p> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-total-annual-contribution" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-total-annual-contribution--7"> <legend> <span class="fieldset-legend">Total Annual Contribution</span> </legend> <div class="fieldset-wrapper"> <div class="js-webform-computed" data-webform-element-keys="contribution_amount_per_pay_period,number_of_pay_periods_for_donation,amount_of_ck,amount_of_cash_donation,amount_of_your_one_time_donation,monthly_cc"><div class="js-webform-computed-wrapper" id="webform-computed-total_donation-wrapper"> <div class="js-form-item js-form-type-item form-type-item js-form-item-total-donation form-item-total-donation mb-3"> <label>TOTAL: $</label> 0<input data-drupal-selector="edit-total-donation" type="hidden" name="total_donation" class="form-control" /> <input formnovalidate="formnovalidate" class="js-hide js-webform-computed-submit button js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-total-donation-update" type="submit" id="edit-total-donation-update--7" name="webform-computed-total_donation-button" value="Update" /> </div> </div></div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-designations" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-designations--7"> <legend> <span class="fieldset-legend">Donation Details</span> </legend> <div class="fieldset-wrapper"> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-designation-options form-item-designation-options mb-3"> <label for="edit-designation-options--7">Designation Options</label> <div id="edit-designation-options--7" class="js-webform-checkboxes webform-options-display-side-by-side checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-united-way-santa-cruz-county-fund form-item-designation-options-united-way-santa-cruz-county-fund"> <input data-drupal-selector="edit-designation-options-united-way-santa-cruz-county-fund" aria-describedby="edit-designation-options-united-way-santa-cruz-county-fund--7--description" type="checkbox" id="edit-designation-options-united-way-santa-cruz-county-fund--7" name="designation_options[United Way Santa Cruz County Fund]" value="United Way Santa Cruz County Fund" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-united-way-santa-cruz-county-fund--7"> United Way Santa Cruz County Fund </label> <small class="description text-muted"> <div id="edit-designation-options-united-way-santa-cruz-county-fund--7--description" class="webform-element-description">Let United Way volunteers administer funds to the greatest needs in our community.</div> </small> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-designation-options-specific-agency form-item-designation-options-specific-agency"> <input data-drupal-selector="edit-designation-options-specific-agency" aria-describedby="edit-designation-options-specific-agency--7--description" type="checkbox" id="edit-designation-options-specific-agency--7" name="designation_options[Specific Agency]" value="Specific Agency" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-designation-options-specific-agency--7"> Specific Agency </label> <small class="description text-muted"> <div id="edit-designation-options-specific-agency--7--description" class="webform-element-description">The organization must be a 501(c)3 tax-exempt organization within the United States.</div> </small> </div> </div> </div> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agency-designations" aria-describedby="edit-agency-designations--7--description" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agency-designations--7"> <legend> <span class="fieldset-legend">Agency Designations</span> </legend> <div class="fieldset-wrapper"> <div data-drupal-selector="edit-flexbox" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox--7"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-webform-states-hidden js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency- form-item-name-of-agency- mb-3"> <label for="edit-name-of-agency---7">Name of Agency #1 </label> <input data-drupal-selector="edit-name-of-agency-" type="text" id="edit-name-of-agency---7" name="name_of_agency_" value="" size="60" maxlength="255" class="form-control" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022designation_options[Specific Agency]\u0022]&quot;:{&quot;checked&quot;:true}}}" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-1 form-item-amount-to-agency-1 mb-3"> <label for="edit-amount-to-agency-1--7">Amount to Agency #1</label> <input data-drupal-selector="edit-amount-to-agency-1" aria-describedby="edit-amount-to-agency-1--7--description" type="number" id="edit-amount-to-agency-1--7" name="amount_to_agency_1" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-1--7--description" class="webform-element-description">Minimum is $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-01" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-01--7"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-2 form-item-name-of-agency-2 mb-3"> <label for="edit-name-of-agency-2--7">Name of Agency #2</label> <input data-drupal-selector="edit-name-of-agency-2" type="text" id="edit-name-of-agency-2--7" name="name_of_agency_2" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-2 form-item-amount-to-agency-2 mb-3"> <label for="edit-amount-to-agency-2--7">Amount to Agency #2</label> <input data-drupal-selector="edit-amount-to-agency-2" aria-describedby="edit-amount-to-agency-2--7--description" type="number" id="edit-amount-to-agency-2--7" name="amount_to_agency_2" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-2--7--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-02" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-02--7"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-3 form-item-name-of-agency-3 mb-3"> <label for="edit-name-of-agency-3--7">Name of Agency #3</label> <input data-drupal-selector="edit-name-of-agency-3" type="text" id="edit-name-of-agency-3--7" name="name_of_agency_3" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-3 form-item-amount-to-agency-3 mb-3"> <label for="edit-amount-to-agency-3--7">Amount to Agency #3</label> <input data-drupal-selector="edit-amount-to-agency-3" aria-describedby="edit-amount-to-agency-3--7--description" type="number" id="edit-amount-to-agency-3--7" name="amount_to_agency_3" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-3--7--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <div data-drupal-selector="edit-flexbox-03" class="webform-flexbox js-webform-flexbox js-form-wrapper form-wrapper mb-3" id="edit-flexbox-03--7"><div class="webform-flex webform-flex--2"><div class="webform-flex--container"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-name-of-agency-4 form-item-name-of-agency-4 mb-3"> <label for="edit-name-of-agency-4--7">Name of Agency #4</label> <input data-drupal-selector="edit-name-of-agency-4" type="text" id="edit-name-of-agency-4--7" name="name_of_agency_4" value="" size="60" maxlength="255" class="form-control" /> </div> </div></div><div class="webform-flex webform-flex--1"><div class="webform-flex--container"> <div class="js-form-item js-form-type-number form-type-number js-form-item-amount-to-agency-4 form-item-amount-to-agency-4 mb-3"> <label for="edit-amount-to-agency-4--7">Amount to Agency #4</label> <input data-drupal-selector="edit-amount-to-agency-4" aria-describedby="edit-amount-to-agency-4--7--description" type="number" id="edit-amount-to-agency-4--7" name="amount_to_agency_4" value="" step="any" min="100" class="form-number form-control" /> <small class="description text-muted"> <div id="edit-amount-to-agency-4--7--description" class="webform-element-description">Minimum $100</div> </small> </div> </div></div></div> <small class="description text-muted"><div id="edit-agency-designations--7--description" data-drupal-field-elements="description" class="webform-element-description">Split your donation among up to 4 agencies. Each donation must be at least $100.</div> </small> </div> </fieldset> <div class="js-form-item js-form-type-checkboxes form-type-checkboxes js-form-item-mark-all-that-apply form-item-mark-all-that-apply mb-3"> <label for="edit-mark-all-that-apply--7">Mark all that apply</label> <div id="edit-mark-all-that-apply--7" class="js-webform-checkboxes webform-options-display-one-column checkbox"> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-i-wish-to-remain-anonymous form-item-mark-all-that-apply-i-wish-to-remain-anonymous"> <input data-drupal-selector="edit-mark-all-that-apply-i-wish-to-remain-anonymous" type="checkbox" id="edit-mark-all-that-apply-i-wish-to-remain-anonymous--7" name="mark_all_that_apply[I wish to remain anonymous]" value="I wish to remain anonymous" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-i-wish-to-remain-anonymous--7"> I wish to remain anonymous </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle form-item-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle" type="checkbox" id="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--7" name="mark_all_that_apply[With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle]" value="With my $100 contribution, I am interested in joining Emerging Leader&#039;s Circle" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-100-contribution-i-am-interested-in-joining-emerging-leaders-circle--7"> With my $100 contribution, I am interested in joining Emerging Leader's Circle </label> </div> <div class="js-form-item js-form-type-checkbox checkbox form-check mb-3 js-form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy form-item-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy"> <input data-drupal-selector="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy" type="checkbox" id="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--7" name="mark_all_that_apply[With my $1,000 contribution, I am interested in joining Women In Philanthropy]" value="With my $1,000 contribution, I am interested in joining Women In Philanthropy" class="form-checkbox form-check-input"> <label class="form-check-label" for="edit-mark-all-that-apply-with-my-1000-contribution-i-am-interested-in-joining-women-in-philanthropy--7"> With my $1,000 contribution, I am interested in joining Women In Philanthropy </label> </div> </div> </div> </div> </fieldset> <fieldset class="js-webform-states-hidden js-webform-type-fieldset webform-type-fieldset js-form-item form-item js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-agreement" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;checked&quot;:true}}}" id="edit-agreement--7"> <legend> <span class="fieldset-legend">Agreement</span> </legend> <div class="fieldset-wrapper"> <div id="edit-markup-01--7" class="js-form-item js-form-type-webform-markup form-type-webform-markup js-form-item-markup-01 form-item-markup-01 form-no-label mb-3"> My signature below, confirms my pledge as stated above. </div> <div id="edit-signature--7" class="js-form-item js-form-type-webform-signature form-type-webform-signature js-form-item-signature form-item-signature mb-3"> <label>Signature</label> <input data-drupal-selector="edit-signature" aria-describedby="edit-signature--7--description" type="hidden" name="signature" value="" class="js-webform-signature form-webform-signature form-control" /><div class="js-webform-signature-pad webform-signature-pad"><input type="submit" name="op" value="Reset" class="button js-form-submit form-submit form-control" /> <canvas></canvas> </div> <small class="description text-muted"> <div id="edit-signature--7--description" class="webform-element-description">Sign above</div> </small> </div> </div> </fieldset> <div data-drupal-selector="edit-captcha" class="captcha"><input data-drupal-selector="edit-captcha-sid" type="hidden" name="captcha_sid" value="19936" class="form-control" /> <input data-drupal-selector="edit-captcha-token" type="hidden" name="captcha_token" value="jUtM2rd0zpi32hakHAuG5uWM3yIGnjf8y8rHz9k7krQ" class="form-control" /> <input data-drupal-selector="edit-captcha-response" type="hidden" name="captcha_response" value="Google no captcha" class="form-control" /> <div class="g-recaptcha" data-sitekey="6LfbHHYrAAAAAL-3T9aJUFflxlPf27G8MJ3zMWdg" data-theme="light" data-type="image"></div><input data-drupal-selector="edit-captcha-cacheable" type="hidden" name="captcha_cacheable" value="1" class="form-control" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions-01" data-drupal-states="{&quot;visible&quot;:{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/pledge-cc&quot;}}}" id="edit-actions-01--7"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-01-submit-7" type="submit" id="edit-actions-01-submit--7" name="op" value="Proceed to Payment Page" /> </div> <div class="js-webform-states-hidden form-actions webform-actions js-form-wrapper form-wrapper mb-3" data-drupal-selector="edit-actions" data-drupal-states="{&quot;visible&quot;:[{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-payroll-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-check-deduction&quot;}},&quot;or&quot;,{&quot;.webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form :input[name=\u0022preferred_donation_method\u0022]&quot;:{&quot;value&quot;:&quot;https:\/\/www.unitedwaysc.org\/thank-you-your-cash-donation&quot;}}]}" id="edit-actions--13"><input class="webform-button--submit button button--primary js-form-submit form-submit btn btn- form-control" data-drupal-selector="edit-actions-submit-7" type="submit" id="edit-actions-submit--7" name="op" value="Submit" /> </div> <input autocomplete="off" data-drupal-selector="form-3optpibvzg4bwo2cbtzcxzgcarvxtehymi1aao5njks" type="hidden" name="form_build_id" value="form-3opTpibVZg4bWo2CBTzcxzgCARVxteHYmi1AaO5NJKs" class="form-control" /> <input data-drupal-selector="edit-webform-submission-pledge-card-central-coast-allian-paragraph-1942-add-form" type="hidden" name="form_id" value="webform_submission_pledge_card_central_coast_allian_paragraph_1942_add_form" class="form-control" /> <div class="url-textfield js-form-wrapper form-wrapper mb-3" style="display: none !important;"> <div class="js-form-item js-form-type-textfield form-type-textfield js-form-item-url form-item-url mb-3"> <label for="edit-url--7">Leave this field blank</label> <input autocomplete="off" data-drupal-selector="edit-url" type="text" id="edit-url--7" name="url" value="" size="20" maxlength="128" class="form-control" /> </div> </div> </form> </div> </div> </div> </div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Sat, 06 Sep 2025 02:23:42 +0000 sysop 1767 at https://www.unitedwaysc.org https://www.unitedwaysc.org/community-resources <span property="schema:name" class="field field--name-title field--type-string field--label-hidden">Community Resources</span> <div class="field field--name-field-header-image field--type-image field--label-hidden field__item"> <img loading="lazy" src="/sites/unitedwaysc/files/styles/internal_page_hea/public/2025-08/Header-Community.jpg?h=6c4a0064&amp;itok=mcSJnx3m" width="2000" height="450" alt="" typeof="foaf:Image" class="image-style-internal-page-hea" /> </div> <span rel="schema:author" class="field field--name-uid field--type-entity-reference field--label-hidden"><span lang="" about="/user/20" typeof="schema:Person" property="schema:name" datatype="">pbenedum</span></span> <span property="schema:dateCreated" content="2011-12-23T01:47:55+00:00" class="field field--name-created field--type-created field--label-hidden">Thu, 12/22/2011 - 5:47pm</span> <div property="schema:text" class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><h2 class="text-align-center">Connecting You to What You Need</h2> <p>A community can be many things. It is people who live in the same neighborhood, city or county.  To us, it is all of these. We work collaboratively to engage the community at all levels and focus resources to improve the lives of our residents. Each resource is made available to community members and organizations to help them become self-reliant and maintain well being.</p> <p><strong>211 Santa Cruz County:</strong><span> a program designed to assist residents of Santa Cruz County to easily connect to a wide variety of health and human services.</span></p> <p><strong>FamilyWize:</strong> prescription drug discount card lowers the price of eight out of 10 prescriptions for an average savings of 35% per prescription.</p> <p><strong>Aging and Senior Care Services: </strong>Santa Cruz County Senior Network Services provides a directory with needs that effect our aging residents.</p> <p><strong>Community Assessment Project:</strong> a consortium of public and private health, education, human service and civic organizations formed to design and implement a comprehensive annual project which reports on the state of our community.</p> <p><strong>Emergency Food and Shelter: </strong>program which augments the emergency food and shelter needs of county residents through qualified providers of services.</p> </div> <div class="bg-edge2edge paragraph paragraph--type--bp-carousel paragraph--view-mode--default carousel slide vbp_color_01" id="vbp-carousel-2020" data-interval="false" data-ride="carousel" > <div class="container"> <div class="row"> <div class="col-12"> <ol class="carousel-indicators"> <li class="" data-slide-to="0" data-target="#vbp-carousel-2020"></li> </ol> <div class="carousel-inner" role="listbox"> <div class="paragraph--layout-slideshow__slide-1 item carousel-item"> <div class="paragraph paragraph--type--bp-simple paragraph--view-mode--default" id="vbp-2019" > <div class="row"> <div class="col-12"> <div class="clearfix text-formatted field field--name-bp-text field--type-text-long field--label-hidden field__item"><h3 class="text-align-center"><span style="color:#ffffff;">Emergency Inclement Weather Support</span></h3> <p class="text-align-center">Stay safe, Santa Cruz County! As severe weather moves through our region, remember that United Way Santa Cruz County and 211 are here to support you.<br />Whether you need info on sandbag locations, road closures, warming centers, or flood advisories, help is just a call or text away.<br />How to connect (24/7, free, &amp; confidential):<br />· Call: 2-1-1<br />· Text: Your ZIP code to 898-211<br />· Web: <a href="211santacruzcounty.org">211santacruzcounty.org</a><br />Please take care of yourselves and your neighbors. We’re in this together!</p> </div> </div> </div> </div> </div> </div> <a class="left carousel-control" href="#vbp-carousel-2020" role="button" data-slide="prev"> <span class="glyphicon glyphicon-chevron-left" aria-hidden="true"></span> <span class="sr-only">Previous</span> </a> <a class="right carousel-control" href="#vbp-carousel-2020" role="button" data-slide="next"> <span class="glyphicon glyphicon-chevron-right" aria-hidden="true"></span> <span class="sr-only">Next</span> </a> </div> </div> </div></div> <div class="field field--name-field-graphic-masking-overlay field--type-entity-reference field--label-hidden field__item"><a href="/taxonomy/term/35" hreflang="en">Solid Dark Red</a></div> Fri, 23 Dec 2011 01:47:55 +0000 pbenedum 303 at https://www.unitedwaysc.org