Campaign Information & Order Form

Please indicate your company's mailing address?

Continuing efforts towards maintaining accurate records, please indicate the total number of employees within your company. Participation percentages, per capita gifts, campaign awards and other significant items will be based on the number that is provided below.

Each employee packet includes a United Way brochure, pledge form, discount prescription card, NC 2-1-1 info and Car Giveaway flyer. Please indicate how many employee packets you will need.

Also, indicate the number of additional items needed for your campaign below.

Our Campaign Advocates including volunteers and Agency representatives are willing to come to speak to your employees on how United Way is improving the lives of local citizens through collaborative efforts.

This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.