2026-2027 United Way of Galveston Pledge Form

UNITED WAY OF GALVESTON

2026-2027 Workplace Giving Pledge Form
Thank you so much for your interest in supporting United Way of Galveston's Annual Workplace Giving Campaign! Please complete the secure form below to make your pledge to or through United Way of Galveston.

Payroll Deductions begin January 1, 2027, unless otherwise specified by your workplace.
Your Workplace

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My Workplace is:
My workplace is not listed. It is:
Your Information

To help us enter and track your pledge
Salutation
First Name
Middle Initial
Last Name
Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Phone Number
Preferred Email Address
example@example.com
Have you given before? Tell us!
___ years.
Let us know if you do not want us to contact you or share your contact information with an organization you designate.
YOUR CONTRIBUTION

How would you like to give?
1. EASY PAYROLL DEDUCTION
Tell us how many Pay Periods you have at work (if you are giving via payroll deduction)
Payroll, please make one-time deduction in the month of
(Will be first pay period of the year unless otherwise specified above)
Payroll, please make a recurring deduction in the amount of
Per period giving $ amount
My total Payroll Deduction for the entire year is
Per period giving $ amount * number of pay periods
2. One-time Donation (Cash, checks, or credit card but NOT payroll deduction)
Cash Total
Check Total
Check #
Direct Gift Total (non-payroll giving, i.e. cash, check, or credit card)
PLEASE CHOOSE HOW YOU WOULD LIKE TO INVEST IN YOUR COMMUNITY
Name of Designated Agency/Agencies (leave blank for United Way of Galveston)
If you are designating your gift to more than one organization, please list them here and we will divide your total amount across the organizations. There is a $50 annual minimum/organization requested to accommodate designations.
Total Designation Amount
A $50 minimum contribution is required for each donor designation to another organization. No administrative fees will be charged for designations. Eligible agencies must be a nonprofit 501(c)(3) organization. Please include the address for non-partner agencies of UWG.
Signature
Please check the accuracy of all your entries. Changes cannot be made after December 20, 2026. Thank YOU for investing in United Way of Galveston!

Thank you for your contribution through the United Way of Galveston campaign. No goods or services were provided in exchange for this contribution. Please keep a copy of this information for your tax records. You will also need a copy of your pay stub, W-2 or other employer document showing the amount withheld and paid to a charitable organization. Consult your tax advisor for more information.
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UNITED WAY OF GALVESTON

Your Workplace

Your Information

YOUR CONTRIBUTION

1. EASY PAYROLL DEDUCTION