United Way NELA

United Way of Northeast Louisiana Logo

This form is for workplace PAYROLL DEDUCTION.

To donate by credit card or cash/check, click here.

Your Workplace

Select Your Workplace

Please select the Employee ID of your choice to ensure your Payroll Deduction Pledge is created properly.

Employee ID

Employee ID#

Last 4-SSN

Work Email

Contact Information

First Name

Last Name

Mobile Number

Please check box to confirm you have reviewed your email for accuracy. A pledge confirmation will be sent to the email you provide. We are unable to resend confirmations and advise you document your elections should the email not deliver properly.

Home Address

City

State

Zip

Payroll Deduct Pledge

Select Pledge Type

My employer has this many pay periods in a year

Amount Per Pay Period

I'd like to donate the following per month:

$0.00

Leadership Giving Societies

An annual gift of $500 or more qualifies you for membership in:

Bayou Society..........$500 - $999
Steamboat Society
- Commander...........$1,000 - $1,499
- Captain..................$1,500 - $2,499
- Commodore...........$2,500 - $4,999
- Admiral......... .........$5,000 - $9,999
Alexis de Tocqueville Society........$10,000+

I am interested in Young Leaders United (40 years old or younger)

I'd like to combine my gift with my spouse.

Spouse Name (First, MI, Last)

Spouse Workplace

I wish to remain anonymous. By checking here my/our name will NOT be published.

Please publish my/our name as:

To reduce cost and waste, United Way of Northeast Louisiana uses email and text as our main forms of communication. By providing your email and/or mobile number, you are authorizing United Way to communicate with you via email and/or text message. You may opt out of these communications at any time. We do not sell, trade, or share your contact information with others. No goods or services were provided in exchange for this contribution. Please keep a copy for your tax records. You will also need a copy of your pay stub, W-2, or other employer-provided document showing the amount withheld and paid to a charitable organization. Consult your tax advisor for more information.