Pledge Form : Workplace Campaigns : How To Help : United Way of Lamoille County

Name (Required)

Address (Required)

City (Required)

State (Required)

Zip (Required)

Phone (Required)

Company (Required)

I authorize my employer to deduct this amount from each paycheck:

bkk7r13r6ea9

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)

Workplace Campaigns