Preferred Donation Method Payroll Deduction Check Cash Credit Card / ACH Round Up Your Change To complete your donation, please click here. To complete your donation, please click here. Your Information Your Name Title First Last Your Contact Information Company/Workplace Email (personal is preferred in case you change jobs or retire) Phone Home Address (please include city and zip code) Payroll Deduction Contribution Amount Per Pay Period $5 $10 $20 $25 $50 Other… $ Number of Pay Periods for Donation One Time 12 pay periods 24 pay periods 26 pay periods 52 pay periods Other… $ Total Donation TOTAL: $0 Update Check Donors Amount of Check $5 $10 $20 $25 $50 Other… $ Frequency of Checks One Time Semi Annually Quarterly Monthly Other… $ Total Donation TOTAL: $0 Update Cash Donations Amount of Cash Donation $ Gift instructions or comments (optional) Please tell us how you would like to be involved or recognized: Emerging Leaders (unrestricted $240+ annual gift, under 40 years old) Women United (unrestricted $500+ annual gift) Red Feather Society (unrestricted $1,000+ annual gift) Loyal Contributor (20+ years of giving to any United Way) Please sign me up for the monthly e-newsletter with updates and volunteer opportunities I would like to remain anonymous Please combine my gift with my spouse/partner for recognition purposes. Their name and workplace is listed below: Enter other… Agreement My signature below, confirms my payroll deduction request as stated above. Signature Reset Sign above Birthdate (for verification purposes) Submit CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.