Black HIlls Employee Campaign Step 1 – Please fill in your informationName(Required) First Last Preferred Email(Required) Email Type Work Personal Preferred Phone(Required)Phone Type Cell Work Personal Home Address Street City State Zip Date of Birth My investment will be combined with my spouse/partner My spouse/partner works at Please list my/our name for recognition as: I /we wish to remain anonymous yes Step 2 – Donation OptionsChoose how you would like to contribute Payroll Deduction Credit Card – One Time Bill me ($50 minimum) Text to Give (Monthly and Quarterly options also available) My total donation Credit CardCard Details Cardholder Name My Total Donation Bill me: Bill me now Monthly Quarterly After submitting this pledge form please text UWWCBHILLS to 41444 to complete your payment. Thank you.Step 3 – Tell us how you want your donation to helpUnited Way of Weld County Designated area Where it will do the most good Reading Great by 8 Thrive by 25 Weld’s Way Home Aging Well Connecting Weld Available Tax Credits Colorado Child Care Contribution Credit Available Tax Credits Enterprise Zone – Housing Navigation Center – Weld’s Way Home Last 4 of your SS# (For Enterprise zone donations – Required by State of Colorado) Specific Designation Specific nonprofit/agency – $50 minimum. An adminstrative fee will be deducted.Please fill in name and address below Specific Designation: Nonprofit/Agency Name and Address Δ
