MY INFORMATION

First Name

MI

Last Name

Home Address

City

State

Zip Code

The membership shall be in the name of

Employer Name

Email Address

I would like to remain anonymousI have given to UWCA for 25 years or moreI am retired or plan to retire within the next 12 monthsI have included UWCA in my will or estate plan

Special Donor Notes

MY PLEDGE INFORMATION

TOTAL ANNUAL PLEDGE: $

How would you like to pay your pledge:

Payroll DeductionCredit/Debit CardBill MeSecuritiesDonor-Advised FundPrivate Family Foundation

Credit Card Information

A member of the Major Gifts team will contact you directly to either receive or confirm your credit card information.

Billing Address

Address Line 1

City

State/Province

Postal Code

Donor Advised Fund Information

I intend to request funds through: (this is not a pledge)

PAYROLL DEDUCTION

Select your number of pay periods per year

26 - Bi-Weekly24 - Semi-monthly12 - Monthly52 - Weekly1 - One-time

BILL ME

Please select the frequency that you would like to be billed:

MonthlyQuarterlyOne-time

Preferred billing start date:

PLEASE SEND ME INFORMATION

Sign me up for the United Way Connects enewsletterYoung Philanthropists SocietyWomen UnitedJ. Mason Davis Leadership SocietyVolunteer Opportunities

Please contact Jacob Gordon at 205.458.2046 or builders@uwca.org if you have any questions.

Contact Information

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