Please print and enclose this pledge form with your contribution/pledge.

                                   Callaway County United Way Pledge Form

                                                                          P.O. Box 793
                                                                      Fulton, MO 65251


          Name_______________________________________________________________________

          Address_____________________________________________________________________

          City/State/Zip_________________________________________________________________

          Phone Number___________________________Email Address_________________________


                                     I/we pledge $________ to the Callaway County United Way.

          □ Cash or Check (enclosed)                                                       □ I would like to be billed

          □ By credit card (please choose) □ One Time □ Monthly □ Quarterly

                                                     □ Visa                    □ Mastercard

          Card #__________________________________________ Expiration date_______________

          Signature__________________________________


                  Your United Way contribution is an investment in our community - Thank you!

No goods or services were provided in consideration for this contribution; therefore, the full amount of your United Way donation qualifies as a tax deduction. 

If you make a gift of $250 or more a federal tax provision requires that you obtain a receipt, which United Way will send in January.