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UVM United Way Campaign Payroll Deduction Pledge Form

UVM United Way Campaign Logo
Thank you for participating in the UVM United Way Campaign.We have set a goal of raising $100,000 in our employee and retiree campaign. 

You may use this on-line form to make a PAYROLL DEDUCTION pledge. Your pledge will be deducted in equal installments from each of your paychecks during the 2020 calendar year.

You may also make a donation using a credit card, but we cannot accept those payments using this form. Please follow this link to a special on-line credit card pledge form hosted by the United Way of Northwest Vermont:!/donation/checkout

If you have any questions, please send an e-mail to or call 802-656-0534.
There are 14 questions in this survey.

Donor Information

(This question is mandatory)
Please enter your contact information:
Your "NetID" is your UVM Network ID, which is what you use to login to your e-mail account (e.g., jsmith1, ftuttle, etc.)
Please indicate if you are a NEW DONOR to the UVM United Way Campaign this year.
Please indicate if you are a Loyal Contributor (you have contributed to any United Way for 10 years or more).

Payroll Deduction Pledge Information

This on-line form can only be used to make payroll deduction pledges.

If you would like to make a donation via credit card or check, please follow this link to print, complete and mail a paper pledge form:

Please indicate the amount of your payroll deduction pledge, below. Your pledge will be deducted in equal installments from all of your paychecks in calendar year 2020.
(This question is mandatory)
How many times per year do you receive a paycheck?

Most UVM employees work 12 months, are paid twice a month, and receive 24 paychecks during the calendar year. If you are paid less frequently, please indicate the number of times you are paid each year.

Automatic Pledge Renewal Option

We will send you a courtesy notice each year before we renew your pledge.

UVM Campaign Leadership Giving Levels

UVM has three leadership giving levels:

$500.00 - $749.00: Grace Goodhue Coolidge Leadership Circle
$750.00 - $999.00: George Washington Henderson Leadership Circle
$1,000 and above: Pomeroy Leadership Circle

Please indicate the amount of your leadership pledge, below:

Joint Leadership Giving:

Please combine my gift with that of my spouse/partner to qualify as a Leadership Gift. His/her name and employer are:

United Way in Your Hometown

The best investment in your community!

Please choose your United Way

United Ways in Vermont make sure that your investment has the greatest community impact by allocating your gift to a wide range of coordinated local programs with proven results that directly change and improve lives.

Please direct my contribution to:
SUPPORT FOR UNITED WAY KEY STRATEGIES: As an alternative, I would like my gift to be used to support one or more of the United Way's key strategy areas. (If selecting more than one key strategy area, please show percentage of gift to go to each area.)
DONOR DIRECTED DESIGNATION: I wish to direct a portion of my gift (minimum of $72 per organization) to a specific agency. (I understand that the United Way does not provide fiscal or program oversight. The United Way of Northwest Vermont retains 6% of donations designated to agencies other than Vermont United Ways to defray the administrative costs of processing.)

Thank you for your support!

Please let us know if you have any questions or comments.