3. Envelope Top Section
(Information From)
Company Coordinators Please complete the
following sections;
*Partial or full report
*Total Employees ______ Full Time Equivalents (FTE)
*Company Coordinator
*Phone number
*Date
United Way Staff/LE Please complete the
following sections;
*Account #
*Org./Ind. Name
*Campaign year
*Submitted by UWECI staff
4. Envelope Middle Section
(DONOR GIFT BREAKDOWN)
Company Coordinators please complete the pay type sections after
you have verified each pledge form.
1.
Amount Enclosed = Dollars in the envelope
Amount Due = Dollar amount your company will remit to UWECI
Total Contribution = Total dollar amount the company
is pledging for this campaign year
5. 2.
a.) Cash/Paid (Includes paid in full checks);
Number of donors= How many donors are giving under this pay type
Amount Enclosed= Dollars in the envelope
Amount Due = Total dollar amount the individuals will remit
to UWECI
Total Contribution = Total amount the individuals are
pledging under this pay type for this campaign year
6. Number of donors= How many donors are giving under this pay
type
Amount Enclosed= Zero (Credit Cards are amount due until
cleared by UWECI)
Amount Due = Total dollar amount of all credit cards
Total Contribution = Total amount the individuals
are pledging under this pay type for this
campaign year
7. Number of donors= How many donors are giving under this pay
type
Amount Enclosed= Zero
Amount Due = Total dollar amount the individuals will remit to
UWECI
Total Contribution = Total amount the individuals
are pledging under this pay type for this
campaign year
8. Number of donors= How many donors are giving under this pay type
Amount Enclosed= Zero
Amount Due = Total dollar amount the individuals will remit to UWECI
Total Contribution = Total amount the individuals are pledging under this
pay type for this campaign year
*Individuals donating stock should complete the UWECI
pledge form and call or email Amy Kelly
Senior Coordinator-Pledge Services at #319-398-5372 x40
or akelly@uweci.org to fulfill their pledged and
stock transfer.
9. Number of donors= How many donors are giving under this pay
type
Amount Enclosed= Zero
Amount Due = Total dollar amount the company will remit to
UWECI
Total Contribution = Total amount the employees
are pledging under this pay type
10. Amount Enclosed= All dollars raised by this Special Event
Amount Due = Zero (Special Events must be paid in full)
Total Contribution = Total amount raised
* Special Event dollars are NOT tax deductible and
MUST be paid separately from donor pledges.
11. Total Employee Giving (Add lines a-f)
Number of Donors = Total of lines a-e
Amount Enclosed = Total of lines a-f
Amount Due = Total of lines a-e
Total Contribution = Total of lines a-f
12. 3 ENVELOPE TOTAL (Corporate + Employee)
Number of Donors = Total Employee Giving from lines a-f
Amount Enclosed = The dollar amount in 1. Corporate Gift + the
dollar amount in Total Employee Giving
Amount Due = The total dollar amount due in 1. Corporate Gift +
the total dollar amount due in Total Employee Giving
Total Contribution = The total contribution amount in 1.
Corporate Gift + the total contribution amount
in Total Employee Giving
13. Employee Group Pledge Spreadsheet
Company Coordinators PLEASE complete this section
Submitted Electronically by:____________________
Date E-mailed:_________________
United Way requests a completed spreadsheet for all envelopes
with 15 or more total donors. The spreadsheet is a verification
of information submitted. United Way electronically captures
donors information allowing for reduced processing
time and risk of error. If you will not be
submitting a spreadsheet please make your
United Way staff contact aware.
Thank you
15. **IT IS IMPORTANT THAT WE HAVE
THE FOLLOWING INFORMATION TO PROCESS PLEDGE CARDS**
*Donors signature
*Name
*Address
*Billing address if different than above address
*Contact information for stock donors
*Credit Card numbers including expiration date, address and zip code
*Completed company corporate card
*Completed company payroll card
*Leadership and Combined Giver information
*For Union recognition please enter your locals name and Local #
*Women’s Leadership requires a minimum of $500
of your pledge be designated to WLI to be recognized.