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United Way Community Campaign
Workplace Campaign Pledge Form (Hoffmaster)
STEP 1: SELECT YOUR UNITED WAY
Please choose from one of the location options below:
Please focus my investment at the following location(s):
Oshkosh Area United Way
Tri-County United Way (Oconto)
United Way of Clintonville
United Way of Northern Nevada and The Sierra (Reno, NV)
STEP 2: MY INFORMATION
First Name
*
Last Name
*
Date of Birth (For Sweepstakes Eligibility)
*
Employee/Badge Number
*
Retiring within the year or on:
New Employer in the last year
Yes
No
Home Address
*
Home Address
Home Address
Home Address
City
City
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Phone Number
*
Phone Type
*
Cell
Home
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Email Address
*
Email Type
*
Personal
Work
Sign me up for the monthly OAUW e-newsletter
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No
Please send me information on planned giving to United Way
Yes
No
STEP 3: MY PLEDGE
Investment Options
*
Please select one option
Payroll Deduction: Per Pay Period
Payroll Deduction: One-Time Only
Credit Card
Check
Bill Me
Per Paycheck Amount
*
$10
$20
$40
$100
$200
Other Amount
Other Amount
x Number of Pay Periods Per Year
= Total Amount
*
Credit Card Amount
*
Help Us Cover the Cost! (Select "Yes!" below to ensure that 100% of your intended donation is available for our mission.)
Yes! Please add 3% to cover processing fees.
No. OAUW will cover the processing fee.
Processing fee.
Pledge Total
Credit Card
One Time Payroll Deduction Amount
*
Check Amount
*
Check Number
Check Date
Please make checks payable to:
Oshkosh Area United Way
.
MAIL TO:
Oshkosh Area United Way
ATTN: Pledge Payment - Hoffmaster Group Inc Employee
16 Washington Ave.
Oshkosh, WI 54901
Bill me the following amount:
*
Bill Me:
Monthly
Quarterly (Jan. 1, Apr. 1, July 1, and Oct. 1)
One-Time
One-Time
Send me a pledge reminder on
STEP 4: RECOGNITION
For recognition, please list my/our name(s) as follows:
In Honor of:
In Memory of:
Would you like to be thanked for your donation?
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I/We prefer to remain anonymous
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