Who is filling out this form?

Email for Person Filling Out Form

Company Name

Employee Campaign Coordinator

Email for Employee Campaign Coordinator

Would you like any employees (1-2 people) to have administrative rights to your ePledge site in order to print pledge reports?

Yes

No

Name of Employee #1

Email Address of Employee #1

Name of Employee #2

Email Address of Employee #2

Total number of pay periods.

What is the date of your campaign kickoff?

What date would you like your ePledge site to close?

Is your organization willing to provide United Way with employee names and email addresses to make the donation process easier for your employers?

Yes

No

What date do you want your campaign kickoff email sent by us?

Do you want us to follow up with ePledge reminder emails?

Yes

No

What date(s) you would like reminder email(s) sent by us?

Submit

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