West Bend Mutual Insurance Company Pledge Form


WORKPLACE PLEDGE CARD

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

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)
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Agreement
My signature below, confirms my payroll deduction request as stated above.

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