If you have any questions when filling out the form please contact Nate Berg at nberg@unitedwayqc.org or call 563.344.0321.
We request that you provide us with contact information for at least two individuals in your organization.
As the person completing the form, the confirmation email will be sent to you.
For a worksheet to help determine your percentage, click here.
(Important: Worksheet is provided for your use only. Please do not return it to us.)
Note: There is no cost to participate in the QC Dividend Program.
If you’d like to make a voluntary contribution to the QC Dividend Program, please use the donate link on the form completion page once you click “submit.”