West Bend Mutual Insurance Company Pledge Form

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The West Bend Annual Giving Guide for full time associates is based upon approximately one hour of pay per month. Associates donating at least the Giving Guide amount may take an additional day of paid time off this year or next year. 

To calculate your annual Giving Guide amount, use ONE of the following options:
 

  • Your hourly pay x 6 (part-time, non-exempt)
  • Your hourly pay x 12 (full-time, non-exempt)
  • Bi-weekly salary x 0.15 (exempt)

You may also make a donation other than the Giving Guide amount.

*The Giving Guide is based on one hour's wages per month for a year.
**To calculate the "per pay" amount, divide by 26.
***PLEASE NOTE: THE WEBSITE WILL AUTOMATICALLY CALCULATE YOUR TOTAL WHEN YOU SELECT AN AMOUNT TO GIVE, SO MAKE SURE TO CHECK IT CAREFULLY BEFORE SUBMITTING. 

WORKPLACE PLEDGE CARD

Preferred Donation Method
Payroll Deduction
$
$0
Is your donation at least the Giving Guide amount?
Cash Donations
$
Is your donation at least the Giving Guide amount?

Credit / Debit Card Donors:

Thank you for your support of the United Way.
To complete your donation by credit or debit card - please click here.

Your Name
Your Contact Information
Designations (Optional)
Invest My Donation In...
Agencies
Agreement
My signature below, confirms my payroll deduction request as stated above.