2007 - United Way Galveston County Mainland



2019/2020 UNITED WAY CAMPAIGN

| Mr. Mrs. Ms. |Name: Jr. Sr. |

|Address: |Email Address: |

|City: |State: |Zip: |

Payroll Deduction

|Pay Periods: Weekly (52) Biweekly (26) Semimonthly (24) Monthly (12) |

|Leadership |

|A gift of .5% of Annual Salary over ____ pay periods = $________ Total |

|Fair Share |

|A gift of ½ hour per pay period over ____ pay periods = $________ Total |

| |

|A gift of $_________ over ____ pay periods = $________ Total |

| |

|A one-time payroll deduction gift of $________ |

OR

One – Time Gift

| |

|A One-Time Gift Is Enclosed: $________ Cash Check (Payable to United Way) |

Do you wish to receive an acknowledgement for your contribution? Yes or No (circle one)

|I wish to receive my acknowledgement by Email |[pic] |I wish to receive my acknowledgement by Mail | |

|(PLEASE PROVIDE EMAIL ADDRESS ABOVE) | |(PLEASE PROVIDE MAILING ADDRESS ABOVE) | |

OPTIONAL: I wish to designate my gift to the following United Way agency: _______________________________

See back for a list of member agencies

Designated agencies must be registered as a nonprofit health and human service agency only with 501(c)(3) status.

If a non-qualifying agency is designated, United Way will redirect these funds to the General Fund.

Designations are available for donors who contribute a minimum of $50 or more.

Signature: ___________________________________________ Date: ______________________

Gift Calculator*

|If you pledge |

|this amount |

|Advocacy Center for Children of Galveston County |

|American Red Cross Galveston County Branch |

|The ARC of the Gulf Coast |

|Boy Scouts of America, Bay Area Council |

|Brazos Place |

|CASA of Galveston County |

|Catholic Charities of the Archdiocese of Galveston-Houston |

|The Children’s Center, Inc. |

|City of Texas City Senior Program |

|Connect Transit |

|DePelchin Children’s Center |

|Family Service Center, Inc. |

|Galveston County Food Bank |

|Girl Scouts of San Jacinto Council |

|Gulf Coast Big Brothers & Big Sisters, Inc. |

|Hitchcock Family Welfare |

|Hospice Care Team |

|The Independence Village |

|Interfaith Caring Ministries |

|Lone Star Legal Aid |

|Mainland Children’s Partnership |

|M. I. Lewis Social Service Center |

|NAMI Gulf Coast (National Alliance on Mental Illness) |

|Resource & Crisis Center of Galveston County |

|The Salvation Army of Galveston County |

|Santa Fe Family Service |

|Special Friends, Inc. |

|Sunshine Center, Inc. |

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Step 1: Donor Information

Step 2: Pledge Options

Step 3: Acknowledgement

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