Direct Bill - United Way of East Central Alabama

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Direct Bill

United Way Bill Direct Form

Please Tell Us About Yourself
Name:*
Prefix First Middle Last Suffix
Employer/Organization:*
Home Address:*
Street Address City State ZIP Code
Email Address:*
Phone:*
OUR PRIVACY POLICY: United Way of East Central Alabama is committed to keeping all personal donor or member agency information confidential and secure. We only use personal donor or member agency information to administer our business, and access is extremely limited to those who need it for this purpose. We will only share personal donor or agency information with staff and volunteers who assist United Way with our fundraising, funds distribution, or community impact efforts. We do not sell donor lists or data about our donors and agencies to other entities. In addition, we will not solicit employees at home for United Way donations through mail or by phone. If you have a question or concern, please email uweca@uweca.org or call 256-236-8229.
How Much Would You Like to Contribute?
I want my TOTAL ANNUAL contribution to be:*
How often you would like to receive a pledge reminder?*
You will receive a pledge reminder in the mail based on the frequency you choose. The reminder will be for the outstanding pledge amount due. You will have the ability to remit payment for the outstanding amount due, or you may remit multiple payments over time until the pledge balance is paid in full. Outstanding pledge balances should be paid in full within a 12 month period.
Would You Like to Focus Your Support?
Please Focus My Donation To Support:
- Community Fund: Focus my donation where it's needed the most
- Health: Improving the health & well-being of our residents
- Education: Preparing children for success in school & life
- Financial Stability: Building strong, independent families
- Basic Needs: Helping our most vulnerable
Other Designation:
United Way of East Central Alabama honors designations to all current United Way Community Partners & Initiatives. as well as other United Way organizations serving other counties.
Bill Direct At Home Agreement:*
- I agree to the bill direct donation amount submitted on this form.
Please note that no goods, services, or benefits are given in exchange for your tax-deductible contribution.

United Way Bill Direct Form

Please Tell Us About Yourself

How Much Would You Like to Contribute?

Would You Like to Focus Your Support?