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United Way of Santa Cruz County

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United Way Community Investment Pledge Form - 2012 Campaign

MR/MRS/MS/DR FIRST NAME MI LAST NAME

STATE ZIP HOME PHONE DAYTIME PHONE

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COMPANY NAME

REACH OUT A HAND TO ONE AND INFLUENCE THE CONDITION OF ALL

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Loyal Contributors Program I have been contributing to any United Way since _____ (yyyy)

Thank you for your contribution through the United Way campaign. No goods or services were provided in exchange for this contribution. Please keep a copy of this form for your tax records. You will also need a copy of your pay stub, W-2 or other employer document showing the amount withheld and paid to a charitable organization. Consult your tax advisor for more information.

**The agency you designate to must be a qualified 501(c)(3) tax -exempt nonprofit. A minimum donation of $100 is required to designate to a nonprofit other than United Way. A maximum of 7% of your designated contribution to a non-partner agency will be deducted for cost recovery. United Way sends your contribution with your name and address to the agency you listed above. If we are unable to locate the designated agency or it is not a qualified organization, we will make every reasonable attempt to contact you before redirecting your donation to the Community Investment Fund.

Check Enclosed, made payable to United Way of Santa Cruz County

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123

U C S A N T A C R U ZEMPLOYEE ID NUMBER

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T O T A L ANNUAL GIFT: $

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The most powerful way to invest your contribution! AMOUNT $

INVEST IN ALL 3 GOALS: DISTRIBUTE SO MY GIFT HAS THE MOST IMPACT TO THE GREATEST NEED

FAMILY FINANCIAL STABILITY GOOD HEALTHYOUTH SUCCESSAMOUNT $ AMOUNT $AMOUNT $

INVEST IN UNITED WAY'S GOAL AREAS AS FOLLOWS:

ADVANCING THE COMMON GOOD:CREATING OPPORTUNITIES FOR A BETTER LIFE FOR ALL GIVE TO THE COMMUNITY INVESTMENT FUNDEveryone deserves opportunities for a good life: enough income to support a family through retirement, children who are prepared for success in life and good health.

That's why United Way of Santa Cruz County's Community Investment Fund is focused on the building blocks for a good life:

FAMILY FINANCIAL STABILITYASSISTING OUR FAMILIES TO BE FINANCIALLY STABLE AND INDEPENDENT

• Helping hard-working people obtain job training and family-sustaining wages • Supporting basic needs while increasing financial eduation• Reducing homelessness and increasing affordable housing

YOUTH PREPARING OUR CHILDREN FOR SUCCESS IN SCHOOL AND IN LIFE

• Improving access to quality, affordable child care and early learning opportunities• Partnering with parents, community-based organizations and schools to improve

high school graduation rates• Providing after-school and mentoring programs for at-risk youth

HEALTHENSURING ADULTS AND CHILDREN ACHIEVE GOOD HEALTH

• Advocating for children's healthcare coverage• Increasing access to critical healthcare services• Addressing substance abuse, child abuse and domestic violence

Advancing the common good is less about helping one person at a time and more about changing systems to help all of us. We are all connected and interdependent. We all win when a child succeeds in school, when families are financially stable, when people are healthy.

United Way's goal is to create lasting change by addressing the underlying causes of community problems. Living united means being part of this change. It takes everyone in the community working together to create a brighter future.

JOIN US TODAY AND HELP CREATE OPPORTUNITIES FOR EVERYONE IN SANTA CRUZ COUNTY. WWW.UNITEDWAYSC.ORG

GIVE. ADVOCATE. VOLUNTEER.