United Way Campaign Report Form
Company Name
CEO
CEO Email address
Company's Internal Campaign Leader
Campaign Leader's Email
example@example.com
Campaign Leader's Title with company
Campaign Leader Phone Number
Please enter a valid phone number.
Account #
Awards confirmed
Pacesetter
Employee awards
Total # of Employees
Total # Donors
# Leadership givers
($500/year & up)
This report is
Partial
Final
Type of Gifts Included in Report
Special Events / Fundraisers
Payroll Deduction Pledges
Fully Paid Gifts (checks/cash)
Direct "Bill Me" pledges
Credit Card Pledges
Corporate Pledge
Corporate Match
Corporate Sponsorship
Non Campaign Corporate Leadership
Employee Campaign Awards Criteria
50% employee participation
100% employee participation
50% are "My Share" level or higher (hours pay/ month or 1% of salary)
10% increase in employee giving
$100 or more employee per capita
One or more leadership givers
Campaign Award -Any 3 criteria
LIVE UNITED Award -Any 4 criteria
Special Events Total
Payroll Deduction Pledges
Fully Paid Gifts
Direct "Bill Me" Gifts
Credit Card Pledges
Corporate Pledge
Corporate Match %
Corporate Match Total
Corporate Sponsorship Total
Corporate Sponsorship Program
Corporate Non Campaign Leadership
Amount Previously Reported
Campaign Total
Payments to United Way will be made:
monthly
quarterly
# of pay periods per year
Date payroll deductions begin
/
Month
/
Day
Year
Date
Payroll Contact Name
Payroll Contact Phone
Payroll Contact Email address
example@example.com
File Upload (scanned pledge cards, corporate contribution letter, special events flyers etc)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Billing Address for Account Statements
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Person filing this report
Signature
Submit
Should be Empty: