2025 Campaign Participation Form

Name(Required)

First Last

Your email(Required)

Your Phone(Required)

Company/Organization Name(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Is your business a part of a Union?(Required)

Yes

Local CEO/Leadership Name(Required)

First Last

This would be your President/CEO/Plant Manager etc

Local CEO/Leadership Job Title(Required)

Local CEO/Leadership Contact Email(Required)

Finance/Payroll Contact(Required)

First Last

Please list the person's name who can answer questions about United Way payroll 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 there are multiple ECM's, please list all of their names and emails here (excluding your own).

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 learning how to set 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!

Would you like to have a planning meeting with United Way?(Required)

Yes

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.

Your United Way Workplace Campaign(Required)

Corporate Giving ONLY (no payroll campaign)

Workplace Special Events ONLY (no payroll campaign)

Employee Payroll Campaign

Workplace Special Events

Corporate Giving

Corporate Match

Workplace Campaigns can look different for different companies. Please choose in which way(s) your company participates currently. Select all that apply.

Number of employees(Required)

This would be the actual number of local employees who are able to contribute to your United Way campaign.

Desired Campaign Start Date(Required)

MM slash DD slash YYYY

This is the date that you will begin your workplace payroll campaign.

Desired Campaign End Date(Required)

MM slash DD slash YYYY

This is the date that you will end your workplace payroll campaign. *Please note that your campaign should end before the end of 2025 so reports can be given to your finance/payroll team to start payroll deductions in January 2026.

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.

Do you offer a rollover campaign?(Required)

Yes

I would like to explore this opportunity

A rollover campaign allows payroll contributions to "rollover" year over year without completing a new pledge form. If there are any changes from one year to a next or employees want to designate their funds, a new form must be filled out. We advise that you offer an incentive to increase pledges if you offer a rollover.

Does your company share employee donor details with United Way?(Required)

Certain companies do not provide employee pledge information along with employee donor details/contact information.

Does your Finance/Payroll provide employee donor detail along with payments sent to United Way?(Required)

For United Way to have the most accurate reporting possible, we request employee donor detail reports along with payments. This ensures we are applying payments to the correct pledges.

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

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 payroll deductions to be made?(Required)

Yes

If they do allow one-time deductions, is there a certain month that an employee must make that deduction?

Do you allow your United Way representative to come in to your workplace to share an employee presentation?(Required)

Yes

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

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

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

Some companies offer fun swag, PTO, etc to employees who give at certain giving levels.

Does your company have a retiree program or communicate to your retirees somehow?(Required)

Yes

Some companies continue to communicate through newsletters or events with their employees once they retire. These retirees can still donate and it counts towards the workplace they retired from.

Does your company allow new employees to start payroll giving immediately?(Required)

Yes

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 which is usually in the Fall.

Do you incorporate special event fundraisers in your campaign?(Required)

Yes

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

Does your company participate in Day of Caring?(Required)

Would your company be interested in participating in a Community Field Trip?(Required)

Community Field Trip is a one-day team building event with classroom training, Q&A panel with local nonprofit leaders and community site visits to partner nonprofit agencies. The cost is $2500.

What do you see as greatest areas of opportunity and/or challenges for your United Way campaign?

Do you consider last year's campaign successful?