Pledge Form FNB - Capital Area United Way

Invalid Submission Values

This form is for First National Bank, Performance Bankers, and Performance Data Center employee payroll deductions and "bill me" requests.

If you prefer to donate via credit card, please click here.

Step 1: Donor Information

First Name (required)

Last Name (required)

Department at the Bank(required)

Employee ID (required)

Home Mailing Address (required)

City (required)

State (required)

Zip Code (required)

Email (required)

Example: janedoe@fakeemail.com

Phone Number (required)

Step 2: How Would You Like To Give?
Please complete one of the two options below.
(If you prefer to donate via credit card, please click here.)

Option A: Payroll Deduction*

My total pledge amount for 2023 is

Example: 1,000.50

*NOTE: Deductions will start with the first January 2023 pay period. If your total pledge amount is not divisible equally between 26 payroll cycles, we will round up to the nearest cent.

Option B: Bill Me*

My total pledge amount for 2023 is

Example: 1,000.50

Billling Frequency

Once for the Total

Quarterly

*NOTE: Your first invoice will be mailed in January 2023.

Step 3: Pledge Acknowledgment & Confirmation

Are you an Evergreen giver? By checking the box below, I acknowledge that I want my gift to renew automatically each year. (required)

Yes please automatically renew my gift annually.

No I would like to manually submit my gift annually.

Are you a CHAMP giver? (You are pledging to donate at least an hour of your pay, each month, to CAUW.) (required)

Yes

Are you a LEADERSHIP Giver? (May be combined with your spouse.) (required)

$500+

$1000+

No (less than $500 pledge)

For LEADERSHIP Giving, please combine my gift with my spouse. (List spouse and their employer.)

I would like my thank you to be sent via(required)

I wish my gift to remain anonymous. (Please note: If you choose this option, you will not show up on any listings, even if you are a CHAMP or LEADERSHIP Giver.) (required)

Yes

Signature (required)