Help another senior like Sally get access to a United Way Active Aging program. 1Amount2Name3Payment Make this a recurring monthly gift. Select a Monthly Plan $10 $20 $30 $50 $75 $100 Select an Amount $25 $50 $100 $250 $500 $1200 Other Amount Other Monthly Amount I would like to dedicate this donation. My dedication is*in celebrationin memoryof* Please write any instructions about your donation below (optional)Notify Someone Please mail or email a card to notify someone of this gift. Notification AddressName and email or mailing address of where the card should be sent:Notification MessageMessage to recipient: Name* First name * Last name * This is a corporate donation Company name (only include company name if you want the tax receipt to be made out to the company) Billing Address* Billing Address * City * Province * AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code * Email* Phone Number*Phone NumberPrint your name as you would like it to appear in published materials Please do not publish my name American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Card Number Expiration Month010203040506070809101112 Year20262027202820292030203120322033203420352036203720382039204020412042204320442045 Security Code Cardholder Name Comments(If you give through your workplace and would like this donation to be counted towards your campaign, please include your organization’s name)To finalize our monthly gift, a United Way Customer Care Associate will be in touch via phone within one business day.CAPTCHAHiddenuwlm.ca Donation Tracy GreenHelp Seniors11.01.2019
