Open Sky 2023 Campaign - United Way of Central Massachusetts

(508) 757-5631

mail@unitedwaycm.org

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I Would Like To Make A Contribution By Payroll Deduction

United Way CM Open Sky Campaign Payroll Deduction Form 2023

United Way respects your privacy and does not sell, trade, or disclose your personal information.

Full Name: *

First

Last

Email Address: *

Cell Phone Number: *

Mailing Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Choose your gift amount per pay period: *

$1.00
$2.00
$5.00
$10.00
$15.00
$25.00
Other, please denote amount per pay period below.

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: *

Select Your Designation: *

United Way of Central Massachusetts
United Way of South 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 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: *

United Way of South 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: *

Please fill in the date this form was completed.

Signature: *

Email

I Would Like To Make A Contribution By Credit Card

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I Would Like To Make A Contribution By Venmo or By Mail-In Check

United Way CM Open Sky Campaign Venmo or Mail-In Check Form 2023

United Way respects your privacy and does not sell, trade, or disclose your personal information.

How Would You Like To Make Your Contribution? *

Please Fill In Your Venmo Name: *

Gift Amount Total: *

$25.00
$50.00
$100.00
Other

If other, please write in the desired amount: *

I give the United Way of Central Massachusetts permission to Venmo Request my account for the amount specified above. *

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No

Full Name: *

First

Last

Cell Phone Number: *

Email Address: *

Mailing Address: *

Address Line 1

Address Line 2

City

State

Zip Code

Designation: *

Select Your Designation: *

United Way of Central Massachusetts
United Way of South Central Massachusetts
Women's Initiative
YouthConnect Worcester
Other Agency

Please write in the name of the agency you'd like to contribute to: *

Complete single agency area above. A minimum $52.00 donation 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: *

United Way of South 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 of the boxes you select!)

Today's Date: *

Please fill in the date this form was completed.

Signature: *

Comment

Please fill out the form above then submit and choose one of the following options:

Click Here To donate via Venmo, please send payment to @unitedwaycm.

To donate via check, please make payable to United Way of Central Massachusetts and mail to: 18 Chestnut, Suite 530, Worcester, MA 01608.

To learn more about the impact of your donation, please click here

18 Chestnut Street, Suite 530
Worcester, MA 01608
508-757-5631

United Way fights for the health, education, and financial stability of people in the community.

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