Paper pledge form instructions
Please complete all sections and make sure to sign and date your form.
Employee Pledge Information
Please verify that all of your information is correct. If there are changes that need to be made, please fill them in on the form.
Pledge Committment
Please fill in your total annual pledge. If you are giving via payroll deduction, please complete that line and check the box for "number of pays." If you are paid once a month, check the box for 12 pays. If you are paid bi-weekly, check the box for 24 pays. In the months where you receive 3 paychecks, United Way deductions are only taken out of the first two paychecks.
If you want to do Minutes of Giving, please make sure to check that box as well. Please refer to the chart on the back of the pledge form for your Minutes of Giving amount.
IMPORTANT: The company is no longer able to do one-time payroll deductions. If you sign up for payroll deduction, the same dollar amount must come out of your pay all year long. Please divide your total pledge amount by the number of payroll deductions you have in one year (12 or 24) and use that amount for your deduction. Note that United Way pledges are deducted only on the following schedule: 12 or 24. If there are three pays in a month, the deduction is only taken out of the first two pays.
Cash, checks, stock/securities, "Bill me" and credit cards are all accepted. The "Bill me" option is only available for pledges of $50 or more. Please make all checks payable to "United Way."
Giving Options
If you want your gift to go to a particular United Way, please designate that United Way by checking the appropriate box. If you want part of your gift to go to the United Way and part to go to a particular agency, fill in the amounts in the boxes provided. If the United Way you want to give to is not listed on the form, please fill it in under "Other United Way."
Each Employee Campaign Manager (ECM) will be provided with one paper copy United Way agency codebook. Employees may also look up agency codes for all States in the National Code Book.
If you do not know your agency's code, please fill in the agency name and phone number. A representative from the United Way will call you if there is a problem finding the agency. Or you can call the United Way of Washington County at 724.225.3310 to find out your agency code.
Signature
Please sign and date your form. This is required for your pledge to be processed.
If you donate more than $750, you are a Leadership Contributor. Please fill in how you would like your name to appear in the Washington County, PA United Way Leadership Directory.
Form Processing
Please make sure you sign and date your form, and make a photocopy if you would like for your records. Please make sure to indicate on the form if you are participating in the Minutes of Giving.
Please make sure to return all forms to your ECM by Friday, October 29.