Workplace Coordinator Form

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Title

First

Last

Cell phone

Office phone

What date would you like to start your Workplace Giving Campaign?

What date do you plan to complete your Workplace Giving Campaign?

Total Number of Employees

How many pay periods does your company have in a year?

52 - We are paid weekly.

12 - We are paid once/month.

24 - We are paid twice per month.

26 - We are paid biweekly.

Other…

Would you be interested in scheduling a United Way presentation to your employees to help kick-off your campaign?

We highly encourage companies to include a UWSC speaker in their campaign kick-off. It is an opportunity for UWSC to thank donors for their support, help them understand what UWSC does with the money they donate and how it meets the needs of their community, and provide resources for help that they can share with customers, friends, or family in need.

Does your company participate in Workplace Giving using an inter-company online site for employees to sign-up to give?

Yes

Does your company have a matching gift program?

Please check all that apply.

Yes, we match dollar for dollar.

Yes, we match a portion of employee donations.

Yes, we donate funds based on volunteer hours.

No, we do not match employee donations or volunteer hours.

Other…

Would your company like to be involved with one or more of our Community Drives?

Our Community Drives include a Winter Care Drive in the Fall, our United We Feed Drive before the Holidays, and a Mom & Baby Care Drive in the Spring.

Would your company be interested in scheduling a Day of Action for a group volunteer activity?

For a Day of Action, United Way of Sumner County will match volunteers with a variety of projects needing attention at United Way of Sumner County partner agencies. Examples include landscaping, storage organization, painting, and more.

Do you have a 2nd campus/location in Sumner County?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Number of Employees at 2nd Location

Do you have a 3rd campus/location in Sumner County?

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Number of Employees at 3rd Location

Additional notes/comments: