United Way of Clark, Champaign and Madison Counties

Thank you for considering a pledge to the United Way of Clark, Champaign and Madison Counties. You can be sure that when you give through United Way, your gift is used wisely to help the people right here in our community who need it the most.

For more information on how your donations are used, see the Facts About United Way page on this web site.

Simply fill out the form below, and then click "Submit". For your security, we will send you a pledge form through the mail.

Online Pledge Form Request

Donor Information
First Name *	County
Last Name *	Home Phone
Address *	Business Phone
City *	Company Name
State *	Email Address
Zip Code *	* Required Fields
Comments

(Please double check spelling)

If you prefer, you may fill out the PDF form (66 kb), print it on your desktop printer, and mail it with your contribution to:

United Way of Clark, Champaign & Madison Counties
Clark County 120 S. Center St. P.O. Box 59 Springfield, OH 45501	Champaign County 308 Miami St P.O. Box 735 Urbana, OH 43078	Madison County P.O. Box 589 London, Ohio 43140

Making A Pledge

Online Pledge Form Request

Donor Information