Pledge Card

PLEDGE/DONATION CARD

Your Information
Donation Method
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
$
$
$
Agreement
My signature below, confirms what I have provided on this form to be accurate.

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.

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