Create Pledge

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Click here to view the program guidelines.
The minimum pledge/donation per charity is as follows:
United States: $10 USD
Canada: $10 CAD
Per Payroll Deduction: $1

NOTE: If you want to change your giving selection, no need to cancel, your most recent entry will override what was previously submitted.

Employee Information

Last Name

Last 4 Digits of Social Security

Birth Month

Birth Day

Zipcode

Phone Number

Email Address

Country

Pledge Type

One Time Credit Card Donation Charge a pledge to your credit card. Your credit card will be charged immediately. The amount will be processed in USD and will show up on your statement in USD.

Direct Donation I donated directly to either United Way, Children's Miracle Network, Feeding America, or American Foundation for Suicide Prevention and want to upload my receipt/acknowledgement so my Season of Giving gift can be matched. Please note this can only be done for one charity at a time.

I do not wish to give at this time

Pledge Amount

Amount

.00 USD

Minimum Amount

5.00 USD

Amount

.00 USD

Pay Periods

Yearly Estimate

.00 USD

Use the yearly estimate to estimate how much you will give. Please check with your payroll calendar to get the actual number of payroll periods remaining to calculate the total amount.

Minimum Amount

5.00 USD

Percentage

Salary

.00

Estimated Pledge

.00

Enter your salary to show your estimated pledge. This tool is for your reference only - the amounts entered are not recorded. Payroll will calculate your final pledge based on your actual salary.

Minimum Amount

5.00 USD

Amount

.00 USD

Credit Card Number

CCV

Expiration Date

Date must be in (mm/yy) format

Zipcode

Minimum Amount

5.00 USD

Amount

.00 USD

Image of Charity Contribution Receipt/Acknowledgement Attach image of your charitable donation receipt/acknowledgement from the charity for verification. The file must be either jpg, png, or pdf. Please upload them directly from your computer.

Charities

Pledge Type

Pledge Amount

.00 USD

Please enter the amount of your total pledge you wish to allocate to each charity selected below. Your total distribution must equal the total pledge.

The organizations below are ones you gave to in the past or are the selected partners for the Season of Giving Campaign. If you would like to give to your local United Way or United Way affiliate and it does not appear below, please use the blue Add Charity button.

Charities	Amount Percent Allocation

Remaining Pledge	Total Pledge
.00 USD	.00 USD
%	%

Would you like to provide your contact information to the charity?

Yes

How do you wish to be recognized?

(This gift is from the Smith Family, Mr. and Mrs. Smith, etc)