Pledge Card

Workplace Pledge Card

Your Name

Title

First

Middle

Last

Suffix

Your Contact Information

Company

Phone

Address

City

State

ZIP Code

Donation Method

Preferred Donation Method

Payroll Deduction

Check

Cash

Bill Me

Credit Card

Check Donation

Amount of Check $

Make checks payable to United Way of McMinn and Meigs Counties. Please give the check to your Campaign Coordinator within 24 hours of this pledge.

Cash Donation

Amount of Cash $

Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.

Bill Me Details

Frequency of Invoice

One Time

Quarterly

Monthly

Amount of EACH direct bill $

Credit Card Donation

Select One

One Time Donation

Monthly Recurring Donation

Amount of your One Time Donation $

Amount donated each month $

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

Total Annual Contribution

TOTAL: $0

Agreement

My signature below, confirms my pledge as stated above.

Signature

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Workplace Pledge Card

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