Enter your information for the 2020-2021 United Way campaign. *Note: This form works best with an updated browser such as Chrome or Safari. Enter your information for the 2021-2022 United Way campaign. United Way respects your privacy. We never release or sell donor information.First NameLast NamePhone NumberEmailYour AddressAddress Line 1Address Line 2CityStateZip CodePreviousNextPayroll DeductionAmount Per Pay PeriodNumber of Pay PeriodsTotal Annual GiftPreviousNextPlease add my donation to the Community Impact Fund!I want knowledgable volunteers and community experts to ensure that my dollars go where they are needed the most and will do the most good.Optional: Designate your donation. For gifts $50+Optional, Choose OneBuckle-Up DavieCancer Services, Inc.Davie County 4-HDavie Center for Violence PreventionDavie Family YMCADavie Senior Services Meals on WheelsFarmington Community CenterJust HOPE, Inc.Ignite DavieThe CARes ProjectThe Dragonfly House, CACThe Salvation ArmyOther (see below)Other Designation (not in list above)PreviousNextPlease sign in the yellow box below via your touch screen or your mouse/trackpad below as confirmation of your donation. Signature Sign HereWhen you click “Submit Form” a copy of this form is sent to your HR Manager and United Way. Please contact your HR Manager directly with any questions about payroll deduction. Direct online donation questions can be directed to the United Way at 336-751-0313 or cshrewsbury@davieunitedway.org.PreviousSubmit Form
