Please use the pledge form below to make an online pledge. A bill will be sent to the address that you provide. Note: If you wish to donate now or set up deductions with your credit card please click here. Title - Select -Mr. Mrs. Ms. Dr. First Name Last Name Email Address Spouse's Name Spouse's Email Mailing Address City State Zip Code Phone Number Phone Number (specify cell, work, or home) (Ex. Cell Number) Workplace Pledge Amount ($100 min. annually) $ Please send me a bill for this pledge - Select -Once a year (enter date below) Monthly Quarterly If you selected once-a-year billing, what month do you wish to be billed? My gift qualifies me for membership in the following Leadership Giving societies (check all that apply) - None -Alexis de Tocqueville ($10,000 plus) Leadership Circle ($1,000-$9,999) Women's Leadership Council ($1,000 plus) Young Leaders Society ($365 plus) Peacock Legacy Society - None -Please contact me about how to include United Way in my estate plans. Anonymous - None -I would like for my gift to remain anonymous. This gift is in memory or in honor of:
