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United Way of Lamoille County
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Payroll Pledge Form
 

Your tools for a successful campaign include Campaign Coordinator Timetable,  Campaign Coordinator Guide, and Tips for a Successful Campaign .

 

 
Pledge Form
 
     
Pledge Form
PLEASE NOTE: Your personal information will never be given or sold to anyone. Your e-mail address will only be used to keep you informed of United Way news, events and volunteer opportunities.
*Name
*Address
*City
*State
*Zip
*Phone
E-mail
PAYROLL DONATIONS
*Company
I authorize my employer to deduct this amount from each paycheck:
I am paid:

My total yearly gift is:
Duration of payroll deduction:

SAVE THE PAPER & POSTAGE. (Gifts over $250 automatically receive acknowledgement).
I prefer to make a one-time donation by check (given to HR Dept.)
I would like to designate my gift to another 501(c)(3) health and human service agency. (Note: $100 minimum donation)
Enter the code shown above:
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