Online Pledge Form - United Way of the Greater Lehigh Valley

My Contact Information

Preferred Communication Name

Phone

Email(Required)

Employer

Title

My Pledge

Please enter your total pledge amount:(Required)

I want to support United Way's initiatives:

Community Building Fund:

Give to the area of the greatest need.

Education:

Healthy Aging:

Community Stability:

Mental Health:

Racial Justice and Equity:

Women United:

United Way affinity group dedicated to improving the lives of women, children and families throughout the Lehigh Valley. ($1,000 for membership)

Emerging Leaders:

United Way affinity group of diverse, rising professionals UNITED in building a stronger community. ($500 for membership)

TeenWorks:

United Way affinity group of local teens engaging in community service projects, developing leadership and communication skills and making meaningful connections while giving back to their community.

I wish to allocate a portion of my gift to*: (optional)

Please list the amount(s) and the name(s) of the organization(s):

*Minimum $25 donation per organization. Any organization you select must have IRS Tax Exempt 501 (c)(3) status, and have health or human services as its primary mission. United Way will process all gifts and forward them to eligible agencies as specified by the donor with a 14% charge (not to exceed $250 per donor) to cover supporting costs related to the campaign. If a non-qualifying agency is designated, or less than $25 is gifted, United Way will redirect these funds to the Community Building Fund.

In honor/memory of:

Payment

Payment:(Required)

Amount per paycheck:

Retain pay stubs for tax purposes.

Number of pay periods:

Employee ID:

Frequency:

Recognition:

Year started:

Signature:(Required)

By typing your name below, you agree that your typed name will serve as your electronic signature, and you acknowledge that all the information provided is accurate and truthful to the best of your knowledge.

Name

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