Hospital Campaign | United Way of Chatham County

First Name

Last Name

Address

City

State

Zip

Email Address

UNCHS Employee ID Number

I want to make a pledge through payroll deduction.

I want to pledge a FAIR SHARE gift of one hour’s pay per month through payroll deduction.

I made my donation through the SECC Campaign and designated my gift to the United Way of Chatham County.

Do you want to designate your contribution?

No- Use my gift to help support all United Way funded programs.

Yes ($25 minimum)

Check here if you DO NOT want to receive news about United Way of Chatham County.

First Name

Last Name

Address

City

State

Zip

Email Address

UNCHS Employee ID Number

Hourly Pay Rate

Hours of PTO You Would Like to Donate

Do you want to designate your contribution?

No- Use my gift to help support all United Way funded programs.

Yes ($25 minimum)

Check here if you DO NOT want to receive news about United way of Chatham County.

Mail cash or check with this form to:
United Way of Chatham County
PO Box 1066
Pittsboro, NC 27312

$50 Minimum Donation Required for Bill Me Option

First Name

Last Name

Address

City

State

Zip

Email Address

UNCHS Employee ID Number

I pledge a TOTAL of:

Please bill me:

Do you want to designate your contribution?

No- Use my gift to help support all United Way funded programs.

Yes ($25 minimum)

Check here if you DO NOT want to receive news about United Way of Chatham County.

United Way Campaign at Chatham Hospital