United Way

United Way of the CSRA Logo

For Credit or Debit Cards Donations:

If you would like to give a one-time or recurring donation via credit or debit card please visit our secured payment form by CLICKING HERE!

For Payroll Deduction Donations please fill out the below:

Donor Pledge Information

First Name

Middle Initial

Last Name

Mobile Number

Home Address

City

State

Zip

Date of Birth

Last 4 of SSN (for HR identification purposes only)

Department or School

(Optional) Agency Designation -- Please note: Designations exclude you from receiving a Caring Club card.

Payroll Deduction

How often do you get paid?

How much would you like to donate per pay period? (Please do not enter a dollar sign.)

Annual Pledge Total

$0.00

By completing this form you are authorizing your employer to deduct via payroll the above amount per the pay frequency you have selected. Most payroll deductions begin January 1st. Please see your HR or Payroll Department for more details. If you plan to give a direct gift of cash or check, please forward it to your campaign coordinator for swift processing.

(Optional) Agency Designation -- Please note: Designations exclude you from receiving a Caring Club card. Each designation must be $150 or greater and go to a 501c3 Health and Human Service organization.

I want to join Focus45! ($180+ annual donation & under 45 years of age)

I want to join your Leadership Circle! ($500+ annual donation required)

I wish to receive emails from United Way.