2007 United Way Pledge Form
Name:
______________________________________		 Company:
______________________________________
Address:
______________________________________		 Union Affiliation (If any)
______________________________________
City/State/Zip
______________________________________		 Date
______________________________________

I would like to learn more about volunteer opportunities.
I would like to receive the United Way of the Wabash Valley newsletter.
I would like more information on estate planning and how to include a gift to United Way.
I have remembered United Way in my will/estate plan.

Payroll Deduction

1% of my annual salary
Specific amount of $_______
       each pay period for _______ pay periods.

 Stock/Securities

   $_____________(approx. value)
    I pledge ___________(no. of shares)
    of ________________(name of stock)
Cash Gift

    Enclosed is my one-time gift of
    Cash $_______
    Check $_______ #_______		 Direct Bill (minimum of $50)
 
  My total donation is $___________
    Enclosed is my first payment of $________
    Please bill me for the balance $_________
Quarterly, starting ___________
Annually, starting ___________
Credit Card

Visa Mastercard Discover
American Expres

       cc#_________________________
       exp. date _______

 Please direct my donation to:

    UWWV agency ____________________
    UWWV agency ____________________
    Other United Way __________________
 


My Total Donation ________________________________________________________
(Pledges of $1,000 or more qualify for Vanguard membership)

Signature________________________________________________________________

E-mail________________________________________________________________

Please print form, fill out information and mail to:
United Way of the Wabash Valley • P.O. Box 3094 • Terre Haute, IN 47803-0094 • 812.235.6287 • 800.823.9301