2021 HondaGo Give United Way Pledge Form
RequiredRequired Question(s)
Required 1.
ROLLING WEEKLY DEDUCTION
In consideration of the needs of others and the important service provided through the United Way, I proudly authorize Honda to deduct from my weekly paycheck the amount below from year-to-year until later changed or revoked by me.
(To securely make a one-time or recurring gift via credit card, click here.)
$20 / pay for a total annual gift of $1040
$15 / pay for a total annual gift of $780
$10 / pay for a total annual gift of $520
$8 / pay for a total annual gift of $416
$5 / pay for a total annual gift of $260
$4 / pay for a total annual gift of $208
$3 / pay for a total annual gift of $156
$2 / pay for a total annual gift of $104
$1 / pay for a total annual gift of $52
Other  
Required 2.

To which county United Way would you like to direct your gift?  

Allen
Auglaize
Champaign
Clark
Darke
Delaware
Franklin
Greene
Hardin
Logan
Madison
Marion
Mercer
Miami
Montgomery
Preble
Shelby
Union
Van Wert
Other  
3.
OPTIONAL:  Do you wish to designate your gift to a specific United Way agency or program in that county?  If so, type the name of the agency below.  You may enter more than one agency.  Agencies must be members of the United Way, otherwise the pledge will be donated to the county United Way.  
 

50 characters left.
Required 4.

Associate Number

 

50 characters left.
Required 5.
Please enter the information indicated below.

First Name:
Last Name:
Email Address:
emailaddress@xyz.com
Address 1:
City:
Postal Code:

If you wish to STOP your existing weekly rollover deduction for United Way, OR if you have any other questions, please e-mail Ginger Haynes