Pledge Card TEMPLATE | Griffin-Spalding County United Way

Payroll Deduction

Contribution Amount Per Pay Period

$5

$10

$20

$25

$50

Other…

Please enter the NUMBER only $

Number of Pay Periods for Donation

One Time

12 pay periods

24 pay periods

26 pay periods

52 pay periods

Other…

Please enter the NUMBER of pay periods for this donation

Check Donation

Amount of Check $

Make checks payable to Griffin-Spalding County United Way. Please give the check to your Campaign Coordinator within 24 hours of this pledge.

Cash Donation

Amount of Cash $

Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.

Credit Card Donation

Select One

One Time Donation

Monthly Recurring Donation

Amount of your One Time Donation $

Amount donated each month $

After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!

Total Annual Contribution

TOTAL: $0

Donation Details

Donor Notes

Agreement

My signature below, confirms my pledge as stated above.

Signature