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Preferred Donation Method
Check
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Check Donation
Amount of Check
$
Make checks payable to United Way of the Blue Mountains. Please give the check to your Campaign Coordinator within 24 hours of this pledge.
Cash Donation
Amount of Cash
$
Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.
Credit/Debit Card Donation
Select One
One Time Donation
Monthly Recurring Donation
Amount of your One Time Donation
$
Amount donated each month
$
After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!
Total Annual Contribution
TOTAL:
1
Donation Details
Donor Designation Options
United Way Community Fund
Your best way to help! A gift to United Way’s Community Fund allows you to help more people than a gift to a single nonprofit. 100% of your gift stays right here in our valley.
Specific Agency
You will be required to provide the agencies contact information.
Name of Agency
Amount to Agency
$
Full Mailing Address of Agency
Do you want to designation to an additional agency?
Yes
No
Additional Agency Designation information
Provide the Name, Address and Amount for any additional agency.
Please share my information with my selected United Way and/or Agency
Yes
No
Recognition
Please list me in recognition materials
I wish to remain anonymous
Donor Notes
You are invited to identify your local United Way so that 100% of your donation will go to your local United Way Community Fund, unless you designate another charity below.
My signature below, confirms my pledge as stated above.
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