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How to Fill Out the United Way Pledge Form
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Please review each completed pledge form to ensure the
following items have been correctly and legibly entered.
- Fill in name, address and contact information.
- If you are giving by payroll deduction, fill in your
Social Security number.
- Please check the appropriate boxes to let us know
whether you wish to receive a letter or remain anonymous, or
your contact information has changed in the past year.
- Are you giving through payroll deduction or a direct
gift? Check the appropriate box and fill in the total
amount of your gift. Please enclose your cash or
check with your pledge form. If using a credit card,
please fill in your Visa or MasterCard account number and
expiration date. If your gift is split in portions between
cash, check and /or credit card and payroll deduction,
please indicate the amount of each portion in the total
amount spaces.
- Please note United Way’s Leadership Giving Levels.
Donors who contribute at these generous levels will receive
public recognition from the United Way.
- Be sure to sign and date your pledge form. A payroll
deduction cannot be made without your signature.
Please designate where you want your contribution to go.
You have four options:
- Designate the entire amount toward the United Way
Community Impact Agenda, expressing your confidence in
United Way’s process of allocating funds to effective
agencies.
- Designate your contribution to one or more of United
Way’s “Four Areas of Care.”
- Designate your contribution toward a specific agency.
Designations for up to five agencies may be listed on the
form. Turn your form over and select the code numbers
for agencies you wish to select. Fill in the code number(s)
on the front and indicate the percentage of each agency’s
share of your Total Gift.
- Designate your gift toward the needs in a specific
Southeast Alaska community. Be sure to indicate the name
of the city.
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