United Way of Benton & Franklin Counties
Your Information
 
Company Name *
 
Your Name *
 
Your Email *
 
Your Phone *
 
I am the Campaign Coordinator for my company
Campaign Coordinator Contact
 
Name *
 
Email *
 
Phone *
IT Contact
 
The person responsible for maintaining your email system, network security, and website filtering. We will need to work with this person to make sure the ePledge emails and websites are not blocked by your corporate network security.
 
Name *
 
Email *
 
Phone *
Payroll Contact
 
The person responsible for payroll. We will need to work with this person to ensure that payroll deduction pledges are transmitted to your payroll department correctly, and to make sure that donor payment detail is received for payroll pledges.
 
Name *
 
Email *
 
Phone *
Key Dates and Numbers
 
ePledge kick-off date *
 
ePledge closing date *
 
Total number of employees *
 
Dollar goal for employee contributions *
Payment Options
 
Easy Payroll Deduction
YesNo
** Minimum $1 per pay period or $20 total annual gift, whichever is higher.
 
Credit Card
YesNo
** Minimum $25 total annual gift.
 
Bill Me
YesNo
** Minimum $25 total annual gift.
 
No Gift
YesNo
** Allows employees to submit a $0 gift. This is used by some companies who wish to incentivize or encourage participation in the campaign, even for those who are not giving a dollar amount. Note that this option costs United Way $0.50 per No Gift submitted. If possible, we ask that your company reimburse us for the cost of the No Gift pledges at $0.50 each, after the campaign is closed.
 
Payroll Deduction Start Date
 
Number of Pay Periods Annually
Items marked with an asterisk(*) are required
Verification Code
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