Lubbock Area United Way Logo

Company/Organization

First Name

Last Name

Mobile Number

(Why do we ask? We need your mobile number so if there is a problem on the day of your event, the speaker or a staff member can get hold of you.)

Office Number

Event location

Start Date of United Way Campaign

I would like to request...

Please select one or more option below.

To set up an online pledge form for my company

the email series to send to my coworkers during our campaign.

A speaker(s) for my company's campaign meeting(s).

Does your company offer payroll deduction?

If so, how many pay periods a year will you deduct from? (i.e., 12 pay periods, 24 pay periods)

My company has a new logo / This is our first year using the online pledge form.

Please email your logo to Will Catalan at [email protected].

My company has a new logo / This is our first year using the the email series.

Please email your logo to Will Catalan at [email protected].

Which emails would you like to use?

Please specify which emails you want to use.

The email series includes a personalized link for employees to make their gift. Where would you like us to direct the link?

Link:

Event Date

Event start time:

# of people expected to attend:

Venue Details

If other, please describe.

Event Type

Loaned Executive (if applicable)

Who will we be sharing with? (check all that apply)

Office staff

Sales Team

Medical staff

Educators

Warehouse

Drivers

Other

If other, please describe

Please share anything else a speaker might need to know like where to park, what entrance to use, etc.

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