Workplace Campaign - Template

United is the Way
Make Your Donation October 17 - December 1

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Questions? Contact...

Shelley Simpson
ssimpson@nortlibertyiowa.org
319-626-5716

Pledge Card
Payroll Deduction
$
Check Donation
$

Please make check payable to United Way of Johnson and Washington Counties.

Cash Donation
$
TOTAL ANNUAL DONATION:
0
Credit Card
$
Designations
United Way Initiatives
A Minimum of $50 is required for all United Way of Johnson & Washington Counties Initiative Designations.
Min. $50/year; Donations which do not make the minimum requirement will be directed to UWJWC.
Early Literacy & Grade-Level Reading Programs
Summership Camp Scholarships
Disaster Relief Fund
A Minimum of $50 is required for all Agency Designations.
$
Min. $50/year; Donations which do not make the minimum requirement will be directed to UWJWC.
To view a list of UWJWC Partner Agencies, click HERE
Agreement
My signature below, confirms my information as stated above.
Sign above
Payment Details

About United Way

From your Campaign Champion

Level 1:  Total gift pledged by December 1 of $60 - $119

Eligible for one-time drawings of various swag items.

Level 2:  Total gift pledged by December 1 of $120-$299

Be entered into a quarterly drawing for a half-day off with pay.  Two winners will be selected each quarter in 2026.
Eligible for a quarterly drawing with a Goody prize valued at $25.

Level 3:  Total gift pledged by December 1 of $300 or more.

Receive a birthday pass for a full day off with pay during your birthday month.
Eligible for a quarterly drawing with a Goody prize valued at $50.

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