Workplace Donation

1. Connect
Name*
First Last
Employer (if applicable)*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Home or Cell Phone*
Date of Birth (Optional)
MM slash DD slash YYYY
Save Postage
- Don’t Send a Tax Letter ($250+)
- Email my tax letter.
2. Recognize
How would you like your information handled?*
- I prefer to remain anonymous.
- I would like my name listed.
If so, how would you like your name listed?

If you would like your spouse included, please provide both names.
Consent*

By checking this box I give consent to the United Way of Lee County, Illinois to use my information for purposes of collecting donations for the organization.
Choose a Contribution Method
Choose your pledge method, Credit, Debit and PayPal users will be redirected to PayPal to pay with no account needed. The Total at the bottom is only for choice 3c. Contribute by Credit – Debit – PayPal.
3a. Contribute by Payroll
Payroll Deduction Total Pledge:
Payroll Deduction Amount Per Pay Period:
Payroll Deduction Pledge – I am paid:
- Weekly
- Bi-Weekly
- Semi-Monthly
- Monthly
3b. Contribute by Cash or Check
Cash or Check Total Pledge:

Make checks available to United Way of Lee county.
3c. Contribute by Billing Me
Bill Me ($50 Minimum)Total Pledge:
Bill Me -Send Me an invoice:
- Monthly
- Quarterly
3c. Contribute by Credit – Debit – PayPal
No account needed.
Online donation via Credit/Debit Card or Paypal – No Account Needed.

Enter the amount you would like to donate and when you click on submit you will be taken to PayPal to finish the transaction.
Total
$0.00
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Signature*

MISSION

United Way of Lee County unites people and resources to improve lives and build a stronger community.

DIVERSITY Statement

VISIT OUR OFFICE

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1. Connect

2. Recognize

Choose a Contribution Method

3a. Contribute by Payroll

3b. Contribute by Cash or Check

3c. Contribute by Billing Me

3c. Contribute by Credit – Debit – PayPal

MISSION

DIVERSITY Statement

VISIT OUR OFFICE