United Way of Licking County Logo
This Form is no longer active please go for Annual Dinner to: https://fundraise.givesmart.com/form/ElS8hA?vid=wguwe
Donation Amount
$
How would you like to pay?
Pay With
Credit Card
This is a secure 256-bit SSL encrypted payment
Routing Number
required
What is this?
Account Number
required
What is this?
Account Type
checking
savings
Name on Account
OK
Card Number
required
required
Select the expiration month for your credit card
MM
01
02
03
04
05
06
07
08
09
10
11
12
/
Select the expiration year for your credit card
YY
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
This field is required.
Expired Credit Card
Discover, Mastercard, Visa
3-Digit Card Verification Number
American Express
4-Digit Card Verification Number
OK
CVV
required
What is this?
Donor hereby approves the payment of the donation and/or purchase to United Way of Licking County and in the amount set forth herein.
Google ReCaptcha Response
Total Amount
MAKE DONATION
Processing...