Marion County Public Schools Pledge Form

Workplace Pledge Card - Marion County Public Schools

Title

First

Middle

Last

Suffix

Employee Id #

Company

Phone

Address

City

State

ZIP Code

Please Select Your Department:

Donation Method

Preferred Donation Method

Payroll Deduction

Contribution Amount Per Pay Period

$10

$20

$25

$50

Other…

Please enter the NUMBER only

Number of Pay Periods for Donation

26 pay periods

Other…

Please enter the NUMBER of pay periods for this donation

Start Date

End Date

Credit Card Donation

Select One

One Time Donation

Monthly Recurring Donation

Quarterly Recurring Donation (every 3 months)

Amount of your One Time Donation

Amount donated each month

Amount donated quarterly (every 3 months)

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

Designation Options

United Way Community Impact Fund

Let United Way volunteers administer funds to the greatest needs in our community.

Education

Health

Financial Stability

Mark all that apply

I am a leadership donor

I'm interested in being a board member

I wish to remain anonymous

Agreement

Information message

Upon submission you will receive a confirmation email of your pledge. Please print, sign and date your confirmation recieipt and submit it to Communications & Community Engagement via courier

I authorize the United Way of Marion County to process my pledge the amount selected for my contribution