Join Bergen County’s United
Way.
Your
membership gift makes a world of difference to someone who needs help.
As a member of Bergen County’s United Way, your contribution
creates real and lasting improvements in people’s lives.
Step 1 – My Membership
I want to join Bergen County’s United Way:
As a member of The Bergen Leadership Society with a contribution
of $1,000 or more directed toward important local needs.
As a member of Women United in Philanthropy. Membership
is extended to women who contribute $1,000 or more and vote to
award grants to help women in Bergen County.
As an Individual Member – at any contribution amount.
Step
2 – My Information
Prefix:
*
First Name:
*
Last Name:
Middle Initial:
*
Address:
*
City:
*
State:
*
Zip:
-
Phone Number:
-
-
*E-mail
Address:
*Retype
E-mail:
*
Required Fields
Step 3 – My Contribution
I
wish to pay via Credit Card
Card
Type
Debit
cards with MasterCard or Visa
symbols can also be used
Contribution of $
Account #
Expiration Date:
/
Name on Credit Card:
Frequency
of donation:
Total Contribution $
If you are making
this contribution by credit card,
please go to
Step 4
and submit this form electronically.
I wish to pay
via personal check:
My check for $
is enclosed.
(Please make check payable to Bergen County's United Way.)
If
you are making this contribution by check,
please print and send this page with your contribution
to:
Bergen County's United Way
6 Forest Avenue
Paramus, NJ 07652
Then
please go to Step 4 and
submit this form electronically as well.
Step 4 – My Authorization
By submitting this form,
I authorize the contributions specified above.
Thank you for joining Bergen County’s United Way.
Questions? Call (201) 291-4050 or e-mail info@bergenunitedway.org
