WC Pledge Form | United Way of Acadiana

About You

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About Your Company

Company(Required)

Please select your company from the dropdown menu. If from a school district, select your district.

Department(Required)

Other UW Designation

UL ID#(Required)

School Name(Required)

Please provide school name or office location within your district.

Payroll Deduction Information

If other, please fill out here.

I want to donate....(Required)

Your general donation will go towards impacting health, education, and financial stability in the Acadiana Community.

I want to donate....(Required)

Your general donation will go towards impacting UL of Lafayette's Campus Cupboard and the UWA Care Network.

If other, ($___ amount per check) please fill out amount here.

If you would like to specifically designate your donation to a 501(c)(3) nonprofit organization, please input here.

Information must be included to process designation. You may select one organization per $50 donation. Incorrect entries benefit Untied Way of Acadiana. Administration fees apply. Please provide full address of your designation.

Type Name Here(Required)

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Workplace Campaign Pledge Form

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