United Way Donation
Full Name
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First Name
Last Name
E-mail
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Employee Number
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Phone Number
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Area Code
Phone Number
Donation Amount per Pay Period
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Number of Pay Periods to Deduct Above Amount
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Total
I would like my donation to be designated to
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General United Way Fund
211
American Red Cross
Boy Scouts
Boys & Girls Club
Cancer Navigators
Cave Spring Day Care
Community Kitchen
Family Resource Center
Girl Scouts
Goodwill
Hospitality house
House of the Children Academy
Mammogram Screening Donations - Healthcare Foundation
Mercy Senior Care
Network Day Services
Open Door Home
Rebecca Blaylock Child Development Center
Senior Adult Recreation Center
Salvation Army
STAR House
YMCA
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