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2026 Online Pledge Form

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Make an Impact Through Your Workplace

Thank you for choosing to support our community through your workplace campaign. Your gift to United Way of Northeast Louisiana helps strengthen our region by connecting people and resources to create lasting impact in Youth Opportunity, Healthy Community, Financial Security, and Community Resiliency.

Want to learn more about the work your support makes possible? Explore our Campaign Toolkit to find impact information, videos and stories, community resources, and materials that show how United Way is working across Northeast Louisiana.

Donor Information

Full Name

Street Address

City

State

Zip Code

Preferred Email

Phone Number

Add dashes to phone number

Date of Birth

Spouse/Partner First Name

Spouse/Partner Last Name

Spouse/Partner Date of Birth

Spouse/Partner Employer

Please keep my gift anonymous

Yes

For recognition, please list my donor information as follows: (EX. John & Mary Smith)

Employment Information

Please select the parish where you work.

Caldwell Parish, East Carrol Parish, Franklin Parish, Madison Parish, Morehouse Parish, Ouachita Parish, Richland Parish, Tenses Parish, or West Carroll Parish

Jackson Parish, Lincoln Parish, or Union Parish

Select the company or organization you are associated with.

Select your school or work location.

Leadership Giving

Make an even greater impact in Northeast Louisiana.

Leadership Giving recognizes individuals and families who choose to deepen their investment in our community through United Way of Northeast Louisiana. Leadership donors help strengthen our collective impact and create meaningful opportunities for individuals and families across our region to thrive.

Leadership Giving also provides opportunities to connect more closely with United Way, learn about the needs and opportunities in our community, and see the impact made possible through your support.

Would you like to learn more about Leadership Giving?

Yes, I'd like to learn more.

Not at this time.

How would you prefer us contact you?

Donation Details

Preferred Donation Method

Payroll Deduction

Check

Cash

Credit Card/Debit

Check Donation

Amount of Check Donation

Give check to the administrative office.

Cash Donation

Amount of Cash Donation

Give cash to the administrative office.

Credit/Debit Card

What type of pledged donation is this?

One-Time Pledge Donation

Recurring Pledged Donation

Recurring Frequency

Monthly

Credit Card will be charged 12 times for the $ amount pledged in the 'Amount of Credit Card Donation field'

Quarterly

Credit Card will be charged 4 times for the $ amount pledged in the 'Amount of Credit Card Donation field'

Amount of Credit Card Donation

Are you willing to cover the 4% online processing fee?

Agreement

My signature below, confirms my payroll deduction request as stated above.

Signature

Sign above

Payment Details