Give. Advocate. Volunteer. Live United.

Pledge Form Avera

Invalid Submission Values

    This form is for Avera payroll deductions and "bill me" requests. If you prefer to donate via credit card, please click here.
    Step 1: Donor Information

    Example: janedoe@fakeemail.com

    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*

    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

    Example: 1,000.50

    Billling Frequency
    *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)
    Are you a CHAMP giver? (You are pledging to donate at least an hour of your pay, each month, to CAUW.) (required)
    Are you a LEADERSHIP Giver? (May be combined with your spouse.) (required)
    (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)