CHILDREN & YOUTH

Boy Scouts, Cascade Pacific Council

Girl Scouts, Columbia River Council

Girls Scouts, Pacific Peaks Council

Kidcare

Child Care Resource and Referral

Drug & Alcohol Intervention/Prevention

SENIORS

Retired Seniors & Volunteers Program

Senior Centers through special grants

EMERGENCY & BASIC NEEDS

American Red Cross, Oregon Trail

Columbia Pacific Food Bank

Community House on Broadway

Transitional Housing

Emergency Housing

Energy Self Reliance

HOPE, Inc.

Salvation Army

Turning Point Community Services

Vernonia Cares

Emergency Support Shelter

Women’s Resource Center

DISABILITES & SPECIAL NEEDS

Chehalem Youth & Family Services

Community Access Services

Community Home Health & Hospice

Lifespan Respite Care

Progress Center

Riverside Training Center

Be sure to keep a copy of this form for your tax records

UNITED WAY OF COLUMBIA COUNTY – PLEDGE FORM

Please mail your contribution to P.O. Box 538, Rainier, OR  97048-0538

Phone:  (503) 556-3614              Email:   uwcc@hotmail.com                   www.unitedwayofcolumbiacounty.com

Name:

Area Code & Phone:

Mailing Address:

City, State & Zip

Periodic Contribution $

Times number of pay periods:

Equals Total Pledge of: $

Credit Card Account No:

(Visa, MasterCard & Discover)

Expiration Date (mo/yr):

Signature

o   I wish to remain anonymous and unpublished

Please write organization name if you designate your pledge (minimum gift for designation is $50):

If total includes spouse who works elsewhere, please

list name and employer.

Spouse's name:

Spouse's employer:

Thank you for helping change lives in your community.

 “Neighbors Helping Neighbors.” It’s working in our Community.