Pledge Form PSD - Capital Area United Way

Invalid Submission Values

This form is for 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)

Pierre School District Department(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, click here.)

Option A: Payroll Deduction

Enter the total amount you want to pledge in 2023*

Example: 1,000.50

*NOTE: Deductions start with the first January 2023 pay period.

Option B: Bill Me

Enter the total amount you want to pledge in 2023*

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)