Name
*
First Name
Last Name
Email
*
Phone
*
(###)
###
####
Organization/Company
*
Your role/title
Primary worksite/location(s)
Approximate number of employees at your site
<25
25-49
50-99
100-249
250–499
500+
Best contact for Payroll/HR (name & email)
Do you plan to run a United Way workplace campaign this season?
*
Yes
No
Unsure - need more information
Which giving options do you expect to offer?
*
Select all that apply
Target timing for your workplace campaign
*
September
October
November
January-March
Year-round/Roll over
Not sure yet
Not applicable
Fundraising events or drives
*
Yes - planning at least one
Maybe - exploring ideas
Not this year
If planning or considering events/drives, what types?
Select all that apply
Would you like SVUW support for events/drives?
Corporate support
*
Select all that might apply
Estimated corporate budget range
*
<$1,000
$1,000-$2,499
$2,500-$4,999
$5,000-$9,999
$10,000+
Unsure - please call to discuss
Not Applicable
Would you/your team attend a 45-minute virtual training
*
Which dates and times work best for you?
Please select all that apply.
Preferred format
Who else should be invited?
Please provide names and emails, and we will add them to our distribution list.
What materials do you need?
Select all that apply
If SVUW provides printed campaign materials (like posters, pledge forms, flyers, or toolkits), about how many copies would your workplace need?
How should we deliver materials?
*
Digital only
Printed kit for pick-up
Ship to address below
Not applicable
Shipping address (if applicable)
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Is there anything else we should know?
Would you like occasional SVUW updates on how your campaign impacts the community?
Yes, keep me posted!
No, thanks.
Consent
*
