We want to provide you with every resource available. We also want to be cost-effective in our production of materials. Thank you for completing this important order form for your fundraising supplies. LIVE UNITED! Company Your Current Local Top Manager (CEO, Manager, President, etc.) Company Main Address Mailing Address (if different from Main Address) Billing Address (if different from Main Address or Mailing Address) Company's General Phone Number Website Address Name of Person Completing this Form Your Direct Phone Number (if applicable) United Way Contact at Your Workplace United Way Contact Email Address Workplace Campaign Coordinator for 2017 (if different than contact person) Workplace Campaign Coordinator Email Address Number of Employees When will you begin your fundraising efforts? Approximately when do you expect to wrap up your fundraising efforts? How many United Way Pledge Forms? How many United Way pledge cards? How many 2-1-1/FamilyWize handouts? How many annual reports? How many "Use of Annual Funds" handouts? How many campaign brochures? How many poster packets? How many campaign videos on disc? I am interested in sending my employees a link to the United Way video. - None -Yes No How many report envelopes? I would like a pacesetter banner. - None -Yes No CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions. Submit Leave this field blank