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STEP 1

Please use this form if you'd like to support the community through United Way.

We now offer four options to make giving even more convenient: (1) by credit card, (2) by requesting that we bill you for your contribution, (3) by authorizing payroll deduction through your employer, or (4) by sending us a contribution of cash, check, or stock.

Rest assured this information is for United Way of Tompkins County use only. It will not be shared, in part or total, with any other organizations or outside parties. For more information on privacy and security issues, please see our Privacy and Security Policy page.

The form should take less than 10 minutes to fill out. Or click here for a printable pledge card. (PDF file requires Adobe Acrobat Reader.)

Contact Information
First Name *
Middle Name/Initial
Last Name *
Home Address 1 *
Home Address 2
City *
State *   Zip Code *
   
Day Phone *    Ext.
E-mail *
   
Your Employer
Company Name
Company ID# (optional)
   
Your Contribution
Total Annual Gift $ *
Contribution
Method		 credit card
bill me
payroll deduction
cash, check or stock
   
The Community Fund

The Community Fund combines your donation to United Way of Tompkins County with those of thousands of others to help our neighbors and benefit everyone in Tompkins County. All donations are put into the Community Fund unless you make particular allocation requests.

If you check this box, you don't need to
fill out Option A, Option B, Option C, or Option D below.

I would like to give my entire gift to the Community Fund.

Or you can choose to give all or a portion of your total annual contribution to a particular agency or to another county United Way using one of the options below. (Note: any remainder of your contribution will be placed in the general Community Fund.)

 
Option A Donate a portion of your total annual gift to a specific agency.

I would like to donate $ to the following specific agency:

Please provide the above-named organization with my address so they may acknowledge my gift.
 
Option B Donate a portion of your total annual gift to another county United Way.

I would like to donate $ to another county United Way:

Or enter another county not listed here:

 
Option C Donate a portion of your total annual gift to Hunger & Food Security.

I would like to donate $ to Hunger and Food Security.

 
Option D Donate a portion of your total annual gift to the Urgent Rx Prescription Program.

I would like to donate $ to the Urgent Rx Prescription Program.

 
Exclude From You can also choose to exclude your donation from a specific agency.
Please exclude my gift from:
   
Leaders in Giving: The Livermore Society

The United Way's Livermore Society formally recognizes the leadership support of households making personal gifts of $600 or more to the annual campaign as follows:

  • Alexis de Tocqueville: $10,000 or more
  • Taughannock: $5,000 to $9,999
  • Treman: $2,400 to $4,999
  • Buttermilk: $1,200 to $2,399
  • Ithaca: $600 to $1,199

So, if your gift, or combined gift from you and your spouse/partner, amounts to $600.00 or more, you can be publicly acknowledged as a leader in giving by becoming a member of the Livermore Society.

Would you like to become a member of The Livermore Society?

yes no
  Click here when ready:
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