Campaign Material Request Form

Please fill out the form below to request Campaign Materials!

Date materials are needed by: *

Company Name: *

Phone Number: *

CEO:

Fax Number: *

Address: *

CEO Email:

Total Number of Employees: *

Campaign Chairperson: *

Campaign Chairperson Email: *

Campaign Chairperson Phone Number: *

Supplies Needed: *

2011 Just the Facts Card

2011 UWGA Pledge Card

NFL Schedules

United Way Posters (Standard)

United Way Posters (Customized) (includes pictures of company employees)

Local Video (DVD Only)

Saturday

Staff Speaker: *

Yes, I would like someone from United Way to speak to my staff.

No, I do not need a staff speaker.

Partner Agency: *

Yes, I would like someone from a United Way Partner Agency to speak to my staff

No, I do not need a Partner Agency speaker.

Campaign Ideas: *

Yes, I would like to be provided with some new campaign ideas!

No, I do not need to be provided with campaign ideas.

Key Workers: