Pledge Card

PLEDGE/DONATION CARD

Your Information
Donation Method
This is my first donation to the United Way of South Central Massachutes.
Payroll Deduction
If your employer allows for payroll deductions, please complete this section.  Otherwise all pledges require credit or check payments.
Check Donation
$
Make checks payable to United Way of South Central Massachutes. Please give the check to your Campaign Coordinator within 24 hours of this pledge or mail to UWSCM, 176 Main St., Suite 400, Southbridge, MA 01550.
Cash Donation
$
Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge or mail to UWSCM, 176 Main St., Suite 400, Southbridge, MA 01550
Bill Me
$
Credit/Debit Card Donation
$
$
After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!
Total Annual Contribution
$0
Please choose how you want to invest in your community
I trust volunteers from our community to help United Way invest in local programs that improve the lives of people right here in the towns of South Central MA.
You will be given the option to split your donation between the United Way of South Central MA, the Women's Initiative or United Way of your hometown.
$
Charlton, Dudley, Southbridge, Sturbridge and Webster
$
Must give home address with zip code.
$
$100 or more to become a WI member, but any designation amount is allowed.
Agreement
My signature below, confirms what I have provided on this form to be accurate.
Sign above

Thank you for your contribution. United Way of SCM acknowledges no goods, services or considerations were made for your gift. All designated gifts will be passed to the specifically indicated organization. Your gift is tax deductible to the fullest extent of the law. Please keep a copy of this form for your tax records. Consult your tax advisor for more information.