JBS Campaign Please fill out your pledge information below. Thank you. I work for the following: Headquarters JBS Greeley Beef JBS Greeley Value Added JBS Carriers Department(Required)Select OneBeefPilgrimsPorkShared ServicesEmployee ID(Required)First Name(Required)Last Name(Required)Preferred Email(Required) Personal Address Street Address City State Zip My Contribution – Please choose from one of the options belowOption 1: I authorize the company to deduct the following amount per pay period.I am paid Weekly (52) Every other week (26) I authorize my payroll For one (1) year Continuous until further notice to the company HR or Payroll Department Option 2: I authorize a ONE TIME deduction from my paycheck in the amount ofOption 3: I want to make a ONE TIME donation with my credit/debit card Credit/Debit Amount to charge Credit CardCard Details Cardholder Name Please Direct My GiftDesignation Area of greatest need Reading Great by 8 (reading to learn) Thrive by 25 (mentoring young adults to succeed) Weld’s Way Home (preventing & ending homelessness) Aging Well (supporting older adults) Connecting Weld (increasing visibility & accessibility of resources) Other Enter your home zip code & UWWC will direct your gift to the United Way in your community.If no zip code is entered, your gift will make an impact in Weld County CO.Agency Name and AddressAuthorizationSignature(Required)Date(Required) MM slash DD slash YYYY Δ
