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Campaign Participation Form
Name
(Required)
First
Last
Your email
(Required)
Company/Organization Name
(Required)
Number of employees
(Required)
This would be the actual number of local employees who are able to contribute to your United Way campaign.
Is your business a part of a Union?
(Required)
Yes
No
Local Leadership Contact Name
(Required)
First
Last
This would be your President/CEO/Plant Manager etc
Local Leadership Job Title
(Required)
Local Leadership Contact Email
(Required)
Finance/Payroll Contact
(Required)
First
Last
Please list the person's name who can answer questions about United Way deductions and payments.
Finance/Payroll Contact Email
(Required)
Employee Campaign Manager(s)
(Required)
I am the only employee campaign manager at my workplace
There are multiple employee campaign managers at my workplace
If you have multiple ECM's, please list their names and emails here.
United Way Committee
(Required)
We do have a United Way committee at my workplace
We do not have a United Way committee at my workplace
We do not have a United Way committee at my workplace but I am interested in setting one up
Some companies have an internal committee specifically for their United Way Campaign. This also could be a culture committee or etc but the United Way campaign is organized through this committee.
If you do have a United Way committee, please list all of the committee members names and emails here
This will enable us to add these committee members to our monthly ECM Newsletter!
Workplace Campaign Goal
If you have a goal for this upcoming campaign, please list it here. This goal could be monetarily, increase in participation or education.
Would you like to have a campaign planning meeting with United Way?
(Required)
Yes
No
Unsure at this time
This meeting is with you and/or your committee along with your United Way account manager. This meeting helps you plan your upcoming campaign, create goals and special events. We go over totals and help brainstorm ideas on how to improve your campaign.
Desired Campaign Start Date
(Required)
MM slash DD slash YYYY
Desired Campaign End Date
(Required)
MM slash DD slash YYYY
Do you offer a rollover campaign?
(Required)
Yes
No
I would like to explore this opportunity
A rollover campaign allows employees payroll contributions to continue year over year without completing a new pledge form. Employees can opt out at any time. If there are any changes from one year to a next or designations made, a new form must be filled out. We advise that you offer an incentive to increase pledges if you offer a rollover.
Pledge Form Preference
(Required)
Paper Pledge Forms only
Online Pledge Form only
Fillable PDF pledge form
None, we create our own pledge forms
Mix of paper and online pledge forms
We can offer you paper pledge forms, fillable PDF pledge forms, a mobile pledge form option or a mixture of any of the above depending on your workforce.
Number of Paper Pledge Forms Needed
(Required)
If you are needing paper pledge forms, please let us know how many you will need for your upcoming campaign
How many pay periods are your employees on?
(Required)
Weekly (52)
Every other week (26)
Twice a month (24)
Monthly (12)
Please check all that are available.
Does your company allow one-time deductions to be made from an employees payroll?
(Required)
Yes
No
Unsure
If they do allow one-time deductions, is there a certain month that an employee must make that deduction?
Any month
January
February
March
April
May
June
July
August
September
October
November
December
Do you offer United Way presentations to your employees?
(Required)
Yes
No
I would like to explore this opportunity
These presentations are helpful to get in front of employees to share with them about United Way. We can do presentations in person or by zoom if needed. Presentations can be done in as little as 10-15 minutes.
Does your company offer a matching employee gift contribution?
(Required)
No we do not offer this
Yes we offer this but are not currently contributing in this way
Yes we currently match our employees donations through a corporate donation
No we do not offer this but I would like to learn more
Some companies offer a corporate donation in the form of a match of the employees contributions. These matches can be 50% or 100%. This is a really great incentive for employee giving.
Does your company give a corporate donation towards your United Way campaign?
(Required)
No we are not able to make a corporate donation
Yes we can make a corporate donation but are not currently contributing in this way
Yes we currently make a corporate donation
No we do not currently but I would like to learn more
Some companies contribute a corporate donation to go towards their company campaign.
Does your company offer incentives for your employees who give?
(Required)
Yes, we offer incentives currently for our employees who give
Yes, we offer incentives currently but I would like to learn about more fun or creative incentive ideas
No, currently we are not able to offer incentives
No, currently we are not offering incentives but I would like to learn how to start
Some companies offer fun swag, PTO, etc to employees who give at certain giving levels.
Does your company have a retiree program?
(Required)
Yes
No
Unsure
Some companies continue to communicate through newsletters or events with their employees once they retire.
Does your company incorporate United Way giving during new employee orientation?
(Required)
Yes
No
No, but I would like to learn more
Some companies share United Way information when an employee gets onboarded. This enables them to start giving immediately instead of waiting for their workplace campaign period.
Do you incorporate special event fundraisers in your campaign?
(Required)
Yes
No
No, but I would like to learn more
Some companies host potlucks, jeans day, raffles, cornhole tournaments or other fun events as an extra way to raise money for their workplace campaigns.
If you host special event fundraisers, please list those so we can share with other ECM's
Is your company involved with Day of Caring?
(Required)
Yes
No
No, but I would like to learn more
Would you like to learn of other ways for your employees to be engaged with United Way?
(Required)
Yes
Not at this time
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Who We Are
Purpose, Values & Pillars
Our Team
Our Board
History
Financials
Community Impact
Our Partners
Programs
Funds
Impact
Events
How To Help
Volunteer
Community Investment Committee
Give Back
Workplace Campaigns
DONATE
GET HELP
417.863.7700
info@uwozarks.org
320 N. Jefferson Avenue
Springfield, MO 65806
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