Individual Gift - SURFACE MAIL OPTION
Please print the form below, complete the requested information, and mail it to:
Centre County United Way
2790 West College Avenue Suite 7
State College, PA 16801
Donor Information
Name________________________________________
Address______________________________________
City_________________________State___Zip_______
E-Mail Address_________________________________
Daytime Phone_(_____)_________________
If your company conducts an employee campaign for United Way, do you wish to have this pledge reflected in their total?
Yes - Employer name____________________________
No
Donor Options
General Fund - to be divided among United Way member agencies
Amount $________
Designated Gift
Agency Name____________________
Amount $________
Other United Way:
Location_______________
Amount $________
(Note: Designations must be for a minimum of $50, and made to a health and human service provider in Centre County. United Way cannot guarantee the use of these contributions. Designations less than $50 will be added to the General Fund.)
Payment Options
Enclosed is my check to Centre County United Way, 2790 West College Avenue #7, State College, PA 16801
I will pay by credit card:
Visa
Mastercard
American Express
Discover
Credit Card #: ______________________________
Expiration date:______________________________