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AFRICAN AMERICAN INITIATIVE _ LATINO INITIATIVE PLEDGE FORM

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					                                                                   AFRICAN AMERICAN INITIATIVE                                                                                                                                Thank you for supporting United Way.
                                                                   & LATINO INITIATIVE PLEDGE FORM
                                                                   United Way of Metropolitan Chicago | 75 Remittance Drive, Suite 5828 | Chicago, IL 60675–5828
  MY INFORMATION
  NAME (please print)                FIRST                                                                             MI             LAST                                                                                           Please keep me informed via email about:
                                                                                                                                                                                                                                     I How United Way is making an impact
  HOME ADDRESS                                                                                                                                                                                                                         across Chicagoland
                                                                                                                                                                                                                                     I United Way efforts in the African
  CITY                                                                                                                                                 STATE             ZIP
                                                                                                                                                                                                                                       American community

  PHONE                                               –                       –                                                                                                                                                      I United Way efforts in the Latino community
                                                                                                                                                                                                                                     I United Way efforts in the Asian Pacific
  EMAIL                                                                                                                                                                                                                                American community
                                                                                                                                                                                                                                     I Young Leaders Society (YLS)
                                                                                                                                                                                                                                     I Volunteer opportunities
  EMPLOYER

                                                                                                                                                                                                                                     I Planned giving
  EMPLOYEE WORK LOCATION



THE UNITED WAY AFRICAN AMERICAN INITIATIVE                                                                                  THE UNITED WAY LATINO INITIATIVE
The United Way African American Initiative helps at-risk African American males, ages  Earlier this year, United Way convened agency partners who serve the Latino
10 to 16, transition successfully to adulthood in communities across Chicago. Lead     community as well as a panel of experts comprised of corporations, educators,
agencies are working with community leaders, government and school officials,          foundations and advocacy groups to develop the United Way Latino Initiative. The                                                               In addition to your support of the
congregations and the youth themselves so that                                                                         Latino Initiative will help Latino youth in our                                                                African American Initiative and
African American boys stay on track to graduation,          Please direct my gift as follows:                          region develop an understanding of the value                                                                   Latino Initiative, please consider
understand employment options and assume                                                                               and long-term impact of staying in school, create                                                              a gift to the United Way Endowment.
healthy family and social roles.                            I 100% to the United Way African American Initiative       a self-identity that bridges two cultures and                                                                  The Endowment will provide resources
                                                            I 100% to the United Way Latino Initiative                 assume healthy family and social roles.                                                                        for quick and effective response to
                                                                                                                                                                                                                                      unexpected crisis, stabilize human
                                                                                   ________ % to the African American Initiative                                                                                                      care service when resources are less
BlueCross BlueShield of Illinois is matching, 2-to-1, new and increased            ________ % to the Latino Initiative                                                                                                                available and serve as a source of
contributions of $1,000 or more to the United Way African American                                                                                             ComEd is matching, 2-to-1, new and increased contributions of
                                                                                                                                                               $1,000 or more to the United Way Latino Initiative. Ask your United
                                                                                                                                                                                                                                      revenue to address emerging needs.
Initiative. Ask your United Way representative for details.                        ________ % to United Way of Metropolitan Chicago                                                                                                   Please speak with your United Way
                                                                                                                                                               Way representative for details.
                                                                                                                                                                                                                                      representative or call 312.906.2457
                                                                                                                                                                                                                                      for more information.
Please select payment method and enter total gift below.

I PAYROLL DEDUCTION:
                                                                                                                                                                                                                                      United Way is committed to protecting
                                                           .           X                   =                       .                  OR One-time payroll deduction of                                    .                           your privacy. Information that you
                                  (amt. per pay period )             (# of pay periods )                               (total gift)                                                                                                   provide is used to help in our campaign,
                                                                                                                                                                                                                                      respond to your requests for information
I A CHECK (payable to United Way) is enclosed in the amount of                                                 .
                                                                                                                                                                                                                                      and process your donation.
                                                                                                                                                                                                                                      To donate by credit card over the phone
                                                                                                                                      MY TOTAL ANNUAL GIFT IS $                                       ,                   .           or make a gift of stock, please call
I PLEASE CHARGE MY: I Visa I MasterCard I Discover I AmEx I Diners                                                                                                                                                                    312.906.2257 9am to 5pm Monday–
                                                                                                                                                                                                                                      Friday. For more information, visit
    in the amount of                                           .                                                                                                                                                                      www.uw-mc.org.
                                                                                                                                      MY AUTHORIZATION
    Card #


    Exp.               /                Bill my card after                    /                /                                      Signature (required)                                        Date
                                                                                                                                                                                                                                     T R AC K I N G CO D E :     AF 7
                                  I One-time payment                    I Quarterly                I Monthly
                                                                                                                                                                                                                                     TOP COPY : United Way
     Please select one:                                                                                                                                                                                                              BOTTOM COPY : Company               7–116
                                                                   AFRICAN AMERICAN INITIATIVE                                                                                                                                Thank you for supporting United Way.
                                                                   & LATINO INITIATIVE PLEDGE FORM
                                                                   United Way of Metropolitan Chicago | 75 Remittance Drive, Suite 5828 | Chicago, IL 60675–5828
  MY INFORMATION
  NAME (please print)                FIRST                                                                             MI             LAST                                                                                           Please keep me informed via email about:
                                                                                                                                                                                                                                     I How United Way is making an impact
  HOME ADDRESS                                                                                                                                                                                                                         across Chicagoland
                                                                                                                                                                                                                                     I United Way efforts in the African
  CITY                                                                                                                                                 STATE             ZIP
                                                                                                                                                                                                                                       American community

  PHONE                                               –                       –                                                                                                                                                      I United Way efforts in the Latino community
                                                                                                                                                                                                                                     I United Way efforts in the Asian Pacific
  EMAIL                                                                                                                                                                                                                                American community
                                                                                                                                                                                                                                     I Young Leaders Society (YLS)
                                                                                                                                                                                                                                     I Volunteer opportunities
  EMPLOYER

                                                                                                                                                                                                                                     I Planned giving
  EMPLOYEE WORK LOCATION



THE UNITED WAY AFRICAN AMERICAN INITIATIVE                                                                                  THE UNITED WAY LATINO INITIATIVE
The United Way African American Initiative helps at-risk African American males, ages  Earlier this year, United Way convened agency partners who serve the Latino
10 to 16, transition successfully to adulthood in communities across Chicago. Lead     community as well as a panel of experts comprised of corporations, educators,
agencies are working with community leaders, government and school officials,          foundations and advocacy groups to develop the United Way Latino Initiative. The                                                               In addition to your support of the
congregations and the youth themselves so that                                                                         Latino Initiative will help Latino youth in our                                                                African American Initiative and
African American boys stay on track to graduation,          Please direct my gift as follows:                          region develop an understanding of the value                                                                   Latino Initiative, please consider
understand employment options and assume                                                                               and long-term impact of staying in school, create                                                              a gift to the United Way Endowment.
healthy family and social roles.                            I 100% to the United Way African American Initiative       a self-identity that bridges two cultures and                                                                  The Endowment will provide resources
                                                            I 100% to the United Way Latino Initiative                 assume healthy family and social roles.                                                                        for quick and effective response to
                                                                                                                                                                                                                                      unexpected crisis, stabilize human
                                                                                   ________ % to the African American Initiative                                                                                                      care service when resources are less
BlueCross BlueShield of Illinois is matching, 2-to-1, new and increased            ________ % to the Latino Initiative                                                                                                                available and serve as a source of
contributions of $1,000 or more to the United Way African American                                                                                             ComEd is matching, 2-to-1, new and increased contributions of
                                                                                                                                                               $1,000 or more to the United Way Latino Initiative. Ask your United
                                                                                                                                                                                                                                      revenue to address emerging needs.
Initiative. Ask your United Way representative for details.                        ________ % to United Way of Metropolitan Chicago                                                                                                   Please speak with your United Way
                                                                                                                                                               Way representative for details.
                                                                                                                                                                                                                                      representative or call 312.906.2457
                                                                                                                                                                                                                                      for more information.
Please select payment method and enter total gift below.

I PAYROLL DEDUCTION:
                                                                                                                                                                                                                                      United Way is committed to protecting
                                                           .           X                   =                       .                  OR One-time payroll deduction of                                    .                           your privacy. Information that you
                                  (amt. per pay period )             (# of pay periods )                               (total gift)                                                                                                   provide is used to help in our campaign,
                                                                                                                                                                                                                                      respond to your requests for information
I A CHECK (payable to United Way) is enclosed in the amount of                                                 .
                                                                                                                                                                                                                                      and process your donation.
                                                                                                                                                                                                                                      To donate by credit card over the phone
                                                                                                                                      MY TOTAL ANNUAL GIFT IS $                                       ,                   .           or make a gift of stock, please call
I PLEASE CHARGE MY: I Visa I MasterCard I Discover I AmEx I Diners                                                                                                                                                                    312.906.2257 9am to 5pm Monday–
                                                                                                                                                                                                                                      Friday. For more information, visit
    in the amount of                                           .                                                                                                                                                                      www.uw-mc.org.
                                                                                                                                      MY AUTHORIZATION
    Card #


    Exp.               /                Bill my card after                    /                /                                      Signature (required)                                        Date
                                                                                                                                                                                                                                     T R AC K I N G CO D E :     AF 7
                                  I One-time payment                    I Quarterly                I Monthly
                                                                                                                                                                                                                                     TOP COPY : United Way
     Please select one:                                                                                                                                                                                                              BOTTOM COPY : Company               7–116

				
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posted:10/16/2011
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