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United Way Community Campaign
Workplace Campaign Pledge Form (Winnebago County)
STEP 1: MY INFORMATION
First Name
*
Last Name
*
Date of Birth
*
Home Address
*
Home Address
Home Address
Home Address
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*
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Email Address
*
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Work
Department
*
Winnebago County A&DRC
Winnebago County University Extension
Winnebago County Airport
Winnebago County Child Support
Winnebago County Clerk of Courts
Winnebago County Coroner
Winnebago County Corporation Counsel
Winnebago County District Attorney
Winnebago County Emergency Management
Winnebago County Executive
Winnebago County Facilities & Maintenance
Winnebago County Family Court Commissioner
Winnebago County Finance & Insurance
Winnebago County Health Department
Winnebago County Highway Department
Winnebago County Human Resources
Winnebago County Health Services
Winnebago County Information Systems
Winnebago County Land & Water Conservation
Winnebago County Parks Department
Winnebago County Planning Zoning - GIS Tax Listing
Winnebago County Register of Deeds
Winnebago County Sheriff's Department
Winnebago County Solid Waste Department
Winnebago County Treasurer
Winnebago County Veterans Service
Winnebago County Circuit Courts
STEP 2: 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
*
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: 2020 Pledge Payment - Winnebago County Employee
21 W. New York Avenue
Oshkosh, WI 54901
Send me a pledge reminder in January 2021 for the following amount:
*
STEP 3: MY GIFT DESIGNATION
Please choose up to 3 funding options below:
Please focus my investment to support:
Oshkosh Area United Way's General Fund
Fox Cities United Way
Health
Financial Stability
Early Education
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