| General information |
| First Name |
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| Last Name |
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| Address 1 |
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| Address 2 |
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| City |
State: |
| Zip Code: |
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| Home E-Mail Address |
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| Day Phone: |
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| My Investment in My Community |
My United Way contribution:
I would like to make a One-Time Pledge in the amount of $
I would like to make a Monthly Pledge in the amount of $
for
months.
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| Please Choose how you want to invest in your community. |
option A:
United Way Community Care Fund I want to make the most powerful contribution possible. Please invest my contribution in United Way’s Community Care Fund to may my community a stronger and safer place to live.
Community Care Pledge Amount: $ |
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option B:
Investment By Impact Area
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Promoting Financial Stability (Amount: $)
Strengthening Individuals & Families: (Amount: $)
Meeting Essential Needs: (Amount: $)
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