CiviContribute | United Way of Johnson & Washington Counties

United Way of Johnson & Washington Counites and our partners are committed to ensuring that our region’s most vulnerable families have the support they need in response to the Derecho Storm.

Hosted by United Way in partnership with corporate, nonprofit and foundation entities, and individual donors like you, this fund will allow us to rapidly deploy resources offering emergency relief to families and individuals in need.

Donation Amount

$ 500.00

$ 250.00

$ 100.00

$ 50.00

$ 25.00

Other Amount

Other Amount $

Total Amount

Disaster Relief Fund

First Name *

Last Name *

Current Employer

Street Address (Primary) *

City (Primary) *

State (Home) *

Postal Code (Home) *

Phone-Phone (Primary) *

Email (Primary) *

Credit Card

Card Type

Card Number

Security Code

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Thank you for supporting

United Way of Johnson & Washington Counties, Inc.

Community Disaster Relief Fund

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