Bill Me Later

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Mr.
Mrs.
Ms.
Dr.
First Name *
Middle Initial
Last Name *
EMail *
Address *
City *
State *
Zip *
Daytime Phone
Company Name / Organization
My Total Annual Gift Amount
More plans for Giving
A Dollar a Week ($52.00)
A Quarter a Day for United Way ($91.25)
Red Feather Club ($1,000)
Pace Setter Club Club ($1,200)
Other Amount$0.00
Bill Me *
Full Amount
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Quarterly
Monthly

My Gift of $1000 or MORE: Qualifies me for membership in the Name of Leadership Giving Society. My name will be listed as it appears above.

Please list my/our name(s) as follows:
Anonymous
I prefer that my gift remain anonymous
Select One:
United Way Community Fund. Your investments will be Shared.
Designation. Your investment will go to the agency of your choice.

Choose a Method to Direct Your Gift

Agency Name
Agency Address
Agency Code
Comments

Questions? Email info@unitedwayfrontroyal.org

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