*Campaign Contribution | Missouri Slope Areawide United Way

Your_investment

Contribution Amount

Hero Club Membership - Individual - $ 500.00

Hero Club Membership - Business - $ 1,000.00

United Way Backpack Program Sponsorship - $ 4,000.00

Other Amount

Other Amount $

Total Amount

I want to contribute this amount every for installments

You can specify the number of installments, or you can leave the number of installments blank if you want to make an open-ended commitment. In either case, you can choose to cancel at any time.

I am contributing on behalf of an organization.

New Organization

Organization Name *

Email Address *

Your Information

First Name *

Last Name *

Current Employer

Email Address *

Preferred Phone

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

Designations and Recognition

Would you like to designate your contribution to a specific agency, program or initiative?

Agency Designations

Initiative Designation

Recognition

My gift of $500 or more qualifies me for membership in the Hero Club.

My gift of $1,000 or more qualifies my business for membership in the Hero Club.

My gift of $500 or more qualifies me for membership in the Women United

I prefer that my gift remain anonymous.

Hero Listing

(How would you like your listing to appear, please include spouse here if you would like to be listed together.)

Endowment Gift

I Would like my gift to go to United Way's Endowment Fund.

(A gift of $5,000 or more to MSA United Way's Endowment Fund may qualify for a 40% credit through the North Dakota Charitable Giving Tax Credit. For more information visit www.msaunitedway.org/tax or consult a tax professional.)

County Designation