THANK YOU FOR YOUR DONATION! Page 2 of 2. 2016-2017 Campaign Pledge Card - FINAL.pdf. 2016-2017 Campaign Pledge Card - F
A New Hope Center
Camp Ahwaga
Owego Golden Age Club
ACCORD
Candor Senior Citizens
Owego Gymnastics & Activity Center
Allied Christians of Tioga
Community Care Network of Nichols
Salvation Army
American Civic Association
Family Reading Partnership
Spencer Senior Citizens
American Red Cross –Southern Tier
Franziska Racker Centers
Spencer Van Etten Food Cupboard
Apalachin-Little Meadows Seniors
Girl Scouts of NYPENN Pathways
Spencer Van Etten Youth Association
Apalachin Youth Athletic Assoc.
Literacy Volunteers
Tioga Center Senior Citizens
Barton Senior Citizens
Newark Valley Senior Citizens
Tioga County Boys & Girls Club
Berkshire Senior Citizens
Nichols Senior Citizens
Tioga Outreach (Catholic Charities)
Boys Scouts—Baden Powell Council Northern Tioga Youth League
Waterman Conservation Center
WHY TIOGA UNITED WAY? ...because by giving to ONE organization, you are supporting 30 agencies. ...because you are committed to making our county stronger, healthier & smarter. ...because Tioga United Way supports agencies who provide programs for the elderly, the youth, the disabled, the isolated, the illiterate, the hungry.
Make your PLEDGE TODAY & visit our website @ www.tiogaunitedway.com
2016-2017
CAMPAIGN PLEDGE CARD DONOR INFORMATION (This information will not be shared) PAYMENT METHOD ~ Please Select One Name:___________________________________________
Exp. Date ________________ 3 digit CVV code_______
3. DIRECT BILL
Single payment to be billed ___________________ Date Four Quarterly Payments
4. PAYROLL DEDUCTION (Return this form to your employer)
GIFT AMOUNT How much would you like to pledge?
$_____________
I agree to donate $_______per pay period over ____periods.
PLEDGE DESIGNATION
I would like the Tioga United Way to use my donation where it is most needed.
I would like to designate my donation to the following Tioga United Way Partner Agency: ____________________________________________________________________________________________________________________
I would like to designate my donation to an organization that is not a Tioga United Way Partner Agency: Name:____________________________________________________ Address:__________________________________________________ City:___________________________State:_____Zip:_____________
(An acknowledgment will be sent to the agency you have selected & they will be asked to provide you with a receipt of your donation.)
PLEASE SIGN AND DATE YOUR PLEDGE FORM (REQUIRED) Signature: ___________________________________________________ Date: ___________________________
Contributor’s Receipt (please retain this portion for your own records):
Contribution made to Tioga United Way, Inc. , 24 State Rt. 96, Owego, NY Date:_____________________ Pledge/Contribution Amount $______________ THANK YOU FOR YOUR DONATION!
