General Information (* required fields)
* First Name:
* Last Name:
Employer:
* Address:
Address 2:
* City:
* State:
* Zip Code:
* E-mail:
* E-mail Confirmation:
* Phone Number: --
Payment Amount
I would like to contribute
$ X = Total Annual Contribution of $0

To contribute a percentage of your annual income, please fill in the fields below and choose whether you would like to contribute 0.6% or 1.2% of this income. The results then display per year and
per month.
Annual Income: (Example: 1.2% of $32,000 = $384 a year or $32 a month)
Percentage: 0.6% (or 1 hours pay per month) = Fair Share
1.2% (or 2 hours pay per month) = Super Share

 
Payment Options
We have 4 convenient options to accept your donation: credit card, bank draft, direct bill, and stock giving.
Credit Card
Billing Information
Same as above
First Name:
Last Name:
Address:
Address 2:
City:
State:
Zip Code:
Credit Card Information
Name on Card:
Card Type:
Card Number:
Expiration: /
CVV2: This is the 3 digit number located on the back of your card.
Bill Me at the Address Above
Bank Draft
Account Holder Name:
Bank Name:
Account Type:
Account Number:
Routing Number:
Drivers License Number:
Drivers License State:
Date of Birth: --
Stock Giving
        please call 225-382-3383 to facilitate
Fund Choices
Local Campaign
Capital Development Fund
Additional Information
Comments or Suggestions:
I would like to hear from CAUW and receive
e-newsletters
I am proud to be a United Way donor for more than 15 years



To cancel a recurring payment please e-mail laurag@cauw.org

The above scheduled pledge will remain in effect until the donor informs Capital Area United Way otherwise. No goods or services will be provided to the donor for this contribution. CAUW is a 501c3 tax deductible organization. Tax ID# 72-0447100