Home Nursing Agency United Way Campaign

WORKPLACE PLEDGE CARD

Payroll Deduction
$0
Check Donation
$
Cash Donation
$

Credit / Debit Card Donors:

Thank you for your support of the United Way.
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All donations go to the General Fund and assist those in greatest need, unless you indicate otherwise. Please provide details below.

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My signature below, confirms my payroll deduction request as stated above.

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