Please complete the following and submit at your earliest convenience.
Campaign Champion Name *
Title *
Company/Organization *
Email *
Address *
Phone Number
Local CEO *
Total Number of Employees (we need this number to generate campaign reports) *
When will your organization conduct your campaign? (Please provide start and end dates) *
Campaigns with presentations from United Way staff raise more funds for their community. Please indicate the DATE(S) and TIME(S) you would like a United Way representative to speak with employee groups.
Would you like your presentation(s) from United Way staff to be IN-PERSON or VIRTUAL?
Clear selection
Are you interested in having a dedicated webpage for your campaign?
Clear selection
Are you interested in in-person or virtual volunteer opportunities for employees at your organization?
Clear selection
United Way provides the following campaign supplies. Which supplies would you like to order?
Any additional questions/comments/concerns?
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