We invite you to complete our online pledge card: DONOR INFORMATION Branch County United Way respects your privacy. We NEVER release or sell donor information. First Name * Last Name * Department Home Street Address * City * State * MichiganAlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code * Email Address * Would you like to be anonymous * NoYes Contribution Options CREDIT CARD If you would like to contribute by credit card either as a one time or recurring donationCLICK HERE PAYROLL DEDUCTIONS Completing this payroll deduction section will authorize Community Health Center to begin taking the amount you indicate below out of each of your 26 paychecks in 2015. Contribution amount per pay period Pay period frequency Every 2 weeks (26 pay periods) Please indicate what your company's payroll schedule is Total Gift Please multiply your donation amount per pay period by 26 pay periods to determine your annual gift. Designation Options My preference Education Income Health To help the United Way volunteers make wise decisions about where to put your contribution to work, please select the Impact Areas most important to you: Agency View a listing of our Partner Agencies here. Leadership Giving is $500 or more We can combine your gift with your spouses donation to qualify as a leadership gift. Provide your spouses name How much did your spouse pledge THANK YOU FOR SUPPORTING THE UNITED WAY! CAPTCHAThis question is for testing whether you are a human visitor and to prevent automated spam submissions.