Contact Information

Please provide contact information for an Administrator who can view employee pledge information (Finance/HR/Payroll, etc.)

Campaign Information

Payment Information

Pre-Printed Paper Pledge Card Questionaire

Please provide an Excel file containing the following employee information to Shreya Naseri at snaseri@uwbckr.org: 1) Required: Names and Unique Identifier (Employee ID or Home Address) 2) Preferred: Home Address, Phone Number, & Emails

How do you want your pledge cards sorted? Please number in order of preference

What do you want printed on your pledge cards? Select all that apply

How would you like your pledge cards delivered?

E-Pledge Information

If your United Way representative has contacted you about utilizing e-Pledge, please answer the questions in the box below and return to Shreya Naseri at snaseri@uwbckr.org with an Excel file containing the following employee information: 1) First, Middle, Last Name(include suffix) 2) Employee ID 3) Employee Workplace EMail (for pledge confirmations)

Please choose from the options below for how you would like employees to login to the e-Pledge site:

Case sensitive. Employees will be required to change their passwords upon first login.

Emails:

If yes, choose which emails you would like United Way to send:

Pledge Options:

Please select which Payment Options you would like to offer for employee fully paid gifts (Check all that apply, payroll and credit card are default):
Items marked with an asterisk(*) are required