2024-2025 Pledge Card

WORKPLACE PLEDGE CARD

Payroll Deduction
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NOTE: Payroll deductions for this donation will begin January.
Cash or Check Donation
To donate by cash or check, please print this form and drop off to your supervisor or campaign ambassador or OMC human resources. You can also mail to United Way of Clallam County, PO Box 937, Port Angeles, WA 98362.
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If donating by credit card or ACH, please CLICK HERE to exit this form and complete your online transaction.
PLEASE DISTRIBUTE MY GIFT AS FOLLOWS

By selecting the United Way Community Care Fund, I want my gift to be invested in the most critical needs in Clallam County and distributed in a way that will make the greatest impact in the community.

Please ensure your distributions equal the total contribution you listed above. Distributions not designated below will be allocated to the United Way Community Care Fund.

My gift will be distributed in a way that will make the greatest difference in Clallam County.
Assisting coworkers during emergent difficult times with medical costs, food, utilities, travel or other expenses.
Building a better working environment by promoting togetherness in celebration. (Holiday parties for both children and adults, employee picnic, sports teams, etc.)
Dedicated to providing equipment and services that bring the most benefit for patients locally, such as hospital equipment, nursing, and ongoing staff education programs.
For designations to IRS approved 501©3 agencies not affiliated with United Way of Clallam County, please type in the name and address of the agency. A 10% processing fee will be deducted from designations to non-partner agencies.
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For designations to IRS approved 501©3 agencies not affiliated with United Way of Clallam County, please type in the name and address of the agency. A 10% processing fee will be deducted from designations to non-partner agencies.
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Leadership Giving - $250 or More
United Way of Clallam County has a recognition program for individuals and couples who donate $250 or more to United Way and Partner Agencies.
Agreement
SIGNATURE AUTHORIZING CONTRIBUTION and acknowledging no goods or services were provided in exchange for this contribution. 
Sign above

Thank you for supporting your community!