Online Pledge Form

How would you like to give? *

One-Time (deducted from one paycheck)

Payroll Deduction (deducted from each paycheck)

Credit Card

First Name *

Last Name *

School/Site *

Email Address (if you would like an emailed receipt)

Optional recognition preference (i.e. anonymous; in honor of; combined with spouse or partner):

One-time donation amount: *

I would like the following amount deducted from every paycheck: *

Total donation:

0.00

I have pressed "calculate" (above) and authorize the current total is correct. *

Yes

I hereby authorize my employer to deduct the per-paycheck donation amount from my paycheck for the United Way of Mower County, Inc to begin after January 1. *

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I hereby authorize my employer to deduct the one-time donation amount from my paycheck for the United Way of Mower County, Inc on or after January 1. *

clear

Click here to donate by credit card