WORKPLACE PLEDGE CARD - WASECA SCHOOLS Location Please select the school you are employed at. Central Hartley Intermediate School Junior/Senior High Schol Preferred Donation Method Payroll Deduction Automatic Bank Withdrawal (ACH) Credit/Debt Card Cash/Check Donation Bill Me Payroll Deduction Upon submitting this electronic pledge form, you and your HR/Payroll manager will receive an email confirmation of your payroll pledge. Contribution Amount Per Pay Period $ Number of Pay Periods for Donation One Time Monthly - 12 pay periods Bi-Monthly - 24 pay periods Bi-Week - 26 pay periods Weekly - 52 pay periods Other… # of pay periods Note: Your payroll deduction amount will be divided by your company’s remaining pay periods for your selected deduction. TOTAL: $0 Update Automatic Bank Withdrawal (ACH) ($50 minimum per transaction) Make a secure automatic bank withdrawal. (Staff member will contact you) Preferred method of contact: Email Phone Amount Per Transaction $ Occurrence One Time Monthly - 12 pay periods Quarterly - 4 pay periods TOTAL: $0 Update Credit / Debt Card After you complete your pledge form, we will provide with a link to complete your donation with a credit/debit card. Pledge Amount $ Cash/Check Donation Cash or Check Cash Check Amount $5 $10 $20 $25 $50 Other… $ Check # Mail or drop off your cash/check donation to: Greater Mankato Area United Way 127 S. 2nd St. #190 Mankato, MN 56001 Bill Me ($50 minimum) Invoice will be sent to home address listed below. Bill Me Date Beginning January 2022 Beginning on this date Bill me on Bill Me at Home Amount $ About You First Middle Last Phone Address City State - Select -AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces (Canada, Europe, Africa, or Middle East)Armed Forces AmericasArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFederated States of MicronesiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon ZIP Code Email Address Confirm Email Spouse Pledge If your spouse gives separately, do you want to combine your gift? Yes No Spouse's Name Spouse's Workplace Donor Recognition I prefer to remain anonymous. Please specify how you (and spouse) would like to be listed for recognition purposes. I DO NOT wish to receive a plaque/certificate. Loyal Contributor: Giving to United Way for 10 years or more. Sustaining Gift As a sustaining donor, your gift will continue for three years to support our partner programs and agencies throughout our service area of Blue Earth, Le Sueur, Nicollet and Waseca counties. Continue my gift for three years. Emerging Leaders Under 40 years of age with a minimum annual gift of $250 or a combined minimum annual gift of $500 with spouse. LEARN MORE Yes, I am interested in Emerging Leaders United. Leave a Legacy I/we would like information about planned giving. I/we have included United Way in our estate planning. I will be retiring within the year. I would like information about giving after retirement. Total Annual Pledge Payroll Deduction Grand Total: $0 Update Total Annual Pledge ACH Grand Total: $0 Update Total Annual Pledge Cash/Check Grand Total: $ Update Total Annual Pledge Bill Me Grand Total: $ Update Agreement By signing this Pledge Form electronically, I agree my electronic signature is the legal equivalent of my manual signature on this Pledge Form. I agree to the terms of service. Terms of Service By signing this Pledge Form electronically, I agree my electronic signature is the legal equivalent of my manual signature on this Pledge Form. Greater Mankato Area United Way is a 501(c)3 organization and donations are tax deductible to the fullest extent allowed by law. No goods or services were given in exchange for this contribution. Date Signature CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank
