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United Way CM Workplace Campaign Pledge Form 2023-2024
United Way respects your privacy and does not sell, trade, or disclose your personal information.
Please enable JavaScript in your browser to complete this form.
Full Name:
*
First
Last
Company:
*
AFL Global
African Community Education Program
American Red Cross of Central Massachusetts
Anna Maria College
Ascentria Care Alliance
Assumption University
Atlas Distributing, Inc.
Avient
bankHometown
Bay State Savings Bank
Berkshire Bank
Big Brothers Big Sisters of Central Mass/Metrowest
Bowditch Attorneys
Boys & Girls Club of Worcester
C & S Wholesale Grocers Inc.
Catholic Charities of the Diocese of Worcester
Central Massachusetts Housing Alliance
Chancery Office-Diocese of Worcester
City of Worcester
Clark University
Coghlin Companies, Inc.
College of the Holy Cross
Community Healthlink
Community Legal Aid
Country Bank for Savings
Davis Publications, Inc.
Eaton
Edward Street
Elder Services
Fallon Health
Fletcher Tilton PC
Gannett Fleming (Telegram)
Girls Incorporated of Worcester
Girl Scouts of Central & Western Massachusetts
Greater Worcester Community Foundation
Greenberg, Rosenblatt, Kull & Bitsoli, P.C.
Guild of St. Agnes
Imperial Distributors, Inc.
KomTeK Technologies
Lamoureux, Pagano Associates Architects
LUK Crisis Center, Inc.
LUTCO, Inc.
Massachusetts College of Pharmacy & Health Sciences
Massachusetts Education & Career Opportunities Inc.
Masterman's
Metso Flow Control USA Inc. (Neles USA)
Mirick O'Connell
National Grid
New England Business Media, LLC
O'Brien & Gibbons Insurance Center
Pernet Family Health Service, Inc.
Polar Beverages
Principal Financial Group
Raymond James Financial Services
Regional Environmental Council
Saint Vincent Hospital
Saint-Gobain
SederLaw
Seven Hills Foundation & Affiliates
South Middlesex Opportunity Council
Spectrum Health Systems, Inc.
Stowe & Degon
Sullivan Group
TD Bank
The CASA Project, Inc.
The Feingold Companies
The Hanover Insurance Group Inc.
The Health Foundation of Central Massachusetts, Inc.
The Shine Initiative
Timber Trading Group
UMass Medical School
UMass Memorial Health Care, Inc.
UniBank
Unum Group
UPS
Washington Mills Electro Minerals Company
Webster First Federal Credit Union
Webster Square Day Care Center, Inc.
Worcester Business Development Corporation
Worcester Community Action Council
Worcester Jewish Community Center
Worcester Polytechnic Institute
Worcester Public Schools
Worcester Regional Chamber of Commerce
Worcester State University
Wyman-Gordon - USW Local 2285
YMCA of Central Massachusetts
YWCA of Central Massachusetts
Email Address:
*
Cell Phone Number:
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Mailing Address:
*
Address Line 1
Address Line 2
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I am a new donor:
Yes
No
Preferred Donation Method:
*
Payroll Deduction
Check/Venmo
Bill Me
Credit/Debit Card
Bill Me Options:
*
One Time
Monthly
Quarterly
By selecting the Bill Me option you are consenting to UWCM sending payment reminders to your contact information above.
Bill Me Gift Amount:
*
Gift amount to be billed to you based on the frequency selected above.
Credit/Debit Card Payment
*
One Time Donation
Monthly Recurring Donation
Quarterly Recurring Donation
After completing this form you must go to our Classy 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! https://give.classy.org/WorkplaceCampaigns
Credit/Debit Card Payment Gift Amount:
*
Gift amount to be billed to you based on the frequency selected above. After completing this form you must go to our Classy 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! https://give.classy.org/WorkplaceCampaigns
Amount of Check or Venmo transfer:
*
Make checks payable to United Way of Central Massachusetts and mail to 18 Chestnut Street, Suite 530 Worcester, MA 01608. Venmo handle is @UnitedWayCM
Choose your gift amount per pay period:
*
$2.00
$5.00
$10.00
$15.00
$25.00
Other
Please write in your desired amount per pay period:
*
Number of Pay Periods:
*
Weekly (52)
Biweekly (26)
Semi-monthly (24)
Monthly (12)
One Time Payroll Deduction
Total Gift Amount
*
Designation:
*
Designation (UWCM, UWSCM, Women's Initiative, YouthConnect or other agency)
Split my donation
Select Your Designation:
*
United Way of Central Massachusetts
Women's Initiative
YouthConnect Worcester
Other Single Agency
Please write in the name of the agency you would like to contribute to:
*
Complete single agency area above. A minimum $52.00 donation is required. United Way applies an 5% charge to cover costs of raising and distributing designated gifts. United Way will honor designations intended for any Health and Human Services entity having 501(c)(3) tax exempt status.
United Way of Central Massachusetts:
*
Women's Initiative:
*
YouthConnect Worcester:
*
Other Agencies:
*
Fill in this area with the designation(s) of your choice that you would like your contributions to be made to. A minimum $52.00 donation is required. United Way applies an 5% charge to cover costs of raising and distributing designated gifts. United Way will honor designations intended for any Health and Human Services entity having 501(c)(3) tax exempt status.
How would you like to be recognized for your gift?
(Examples: Mr. & Mrs. John Doe, Anonymous, etc.)
Would you like to learn more about our programs?
Planned Giving
Volunteering
Women's Initiative
(We will reach out to you directly with more information on any boxes you select.)
Today's Date:
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Please fill in the date this form was completed.
Signature:
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