EMPLOYEE GIVING PLEDGE FORM

Thank you for being part of our Employee Giving Campaign!

United Way of Clallam County is committed to helping all residents of our community live safe, healthy, and productive lives. Our annual campaign raises funds to support United Way programs and local nonprofits that we call Impact Partners. These Impact Partners provide wrap-around services to more than 46,600 individuals and families in our community in the areas of Healthy Community, Youth Opportunity, and Financial Security. Giving to United Way is the most effective and impactful way to donate money in Clallam County.

From early childhood education, to safe and affordable housing, to job training and career readiness, United Way of Clallam County is a one-stop-shop for people who want to do the most good for the most people right here at home.

WORKPLACE PLEDGE CARD

Preferred Donation Method

Payroll Deduction

Check or Cash

Credit Card / ACH

Cash or Check Donation

To donate by cash or check, please print this form and drop off to your supervisor or campaign ambassador. You can also mail to United Way of Clallam County, PO Box 937, Port Angeles, WA 98362.

$10

$20

$25

$50

Other…

Amount

If donating by credit card or ACH, please CLICK HERE to exit this form and complete your online transaction.

Employer

Employer's Name

Title

First

Middle

Last

Suffix

Company

Personal Email

Personal Phone #

Home Address

City

State

ZIP Code

The following check boxes apply to communications from United Way:

Don’t list my name.

Don’t release my name to agencies I designate.

My Giving

I choose the Community Care Fund

because I know my gift will be invested in meeting the most critical current needs in Clallam County. My gift will be distributed in a way that will make the greatest impact in the community.

I would like to designate my gift to a specific nonprofit.

For designations to IRS approved 501(c)(3) agencies not affiliated with United Way of Clallam County, a 10% processing fee may be deducted.

Amount to United Way Community Care Fund

Designation

Name of Agency

Must be an IRS 501c3 agency.

Amount to Agency

Street Address

City

State

Zip Code

Do you want to designate to an additional agency?

Yes

Designation 2

Name of Agency

Must be an IRS 501c3 agency.

Amount to Agency

Street Address

City

State

Zip Code

Do you want to designate to an additional agency?

Yes

Designation 3

Name of Agency

Must be an IRS 501c3 agency.

Amount to Agency

Street Address

City

State

Zip Code

Leadership Giving - $250 or More

United Way of Clallam County has a recognition program for individuals and couples who donate $250 or more to United Way and Partner Agencies.

My donation either individually or combined with a spouse totals $250 annually or more

How would you like your name(s) recognized:

Agreement

SIGNATURE AUTHORIZING CONTRIBUTION and acknowledging no goods or services were provided in exchange for this contribution.

Signature

Sign above

Thank you for supporting your community!

This is the general Employee Giving pledge form. If you are an employee of Olympic Medical Center, or Jamestown/7 Cedars, please click on the corresponding logo below to be taken to your particular Employee Giving pledge form.

Red Arches