1Your Gift2Contact Information Hidden Make this a recurring monthly gift. HiddenSelect a Monthly Plan $10 $20 $30 $50 $75 $100 Payment Type(Required) I would like my Employer to deduct my Gift via payroll deduction. I would like to make a gift with my Visa, Master Card, American Express, Google Pay or Apple Pay. HiddenSelect an Amount $25 $50 $100 $250 $500 $1200 Please input the Annual Amount you would like to Give as part of your Workplace Campaign Please click here to make your gift with your Visa, Master Card, American Express, Google Pay or Apple Pay.Please Note: Equal installments will be taken by your Employer based on your current payroll schedule. Gifts made by payroll deduction are tax receipted by your Employer and issued with your T4.Other Monthly Amount I would like to dedicate this donation. My dedication is(Required)in celebrationin memoryof(Required) 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(Required) First name * Last name * Your Employer (Workplace)(Required)Select Your WorkplaceTest Workplace for DemonstrationsAcclaim Health and Community Care ServicesAlternatives for Youth HamiltonAlzheimer Society Foundation of Brant, Haldimand, Norfolk, Hamilton HaltonAmity Goodwill IndustriesAncaster Community ServicesArtHouse For Children And YouthBig Brothers Big Sisters of Halton and HamiltonCanadian Hearing Services Halton-Peel OfficeCanadian Hearing Society Hamilton RegionCanadian Mental Health Association, Halton Region BranchCanadian Mental Health Association, Hamilton BranchCanadian Red Cross Society - HamiltonCatholic Family Services of HamiltonCatholic Youth OrganizationChildren's International Learning CentreCity of BurlingtonCommunity Development HaltonCommunity Living BurlingtonCommunity Living HamiltonCommunity Living North HaltonCommunity Living OakvilleContact Hamilton For Children's and Developmental ServicesDawn Patrol Child & Youth Services Inc.Distress Centre HaltonDundas Community ServicesElizabeth Fry Society of Greater TorontoEva Rothwell CentreFood for Life CanadaForestView ChurchGlobal Citizens Care for Underprivileged & Refugee Empowerment IncGrant Thornton GeorgetownHalton Alcohol Drug Gambling Assessment Prevention and Treatment (ADAPT)Halton Food For ThoughtHalton Multicultural Council Inc.Hamilton and District Literacy CouncilHamilton Council on AgingHamilton East Kiwanis Boys and Girls ClubHamilton Family Health TeamHamilton Family MedicineHIPPY Halton Home-Based ProgramHope Place CentresJohn Howard Society of Hamilton, Burlington & AreaJohn Howard Society Peel Halton DufferinLawrie Insurance Group Inc.Links2Care - Georgetown Head OfficeMilton Community Resource CentreNelson Youth CentresNorth Hamilton Community Health CentreOakville Kiwanis Meals on WheelsOakville Parent-Child CentrePursuit CPARadius Child and Youth ServicesROCK Reach Out Centre for KidsSexual Assault & Violence Intervention Services of Halton (SAVIS)Sexual Assault Centre(Hamilton and Area) SACHASocial Planning & Research Council of HamiltonSt. John Council For Ontario Halton Region BranchSt. John Council For Ontario Hamilton BranchSt. Joseph's Villa DundasSt. Matthew's HouseSupport HouseSupported Training and Rehabilitation in Diverse Environments (STRIDE)The Lighthouse Program for Grieving ChildrenThe Living Rock MinistriesThe Women's Centre of HaltonThreshold School of BuildingThrive Counselling Services Halton Inc.United Way Halton & HamiltonWelcome Inn Community Centre of HamiltonWesley Urban Ministries Inc.Wever Community HubYMCA of Hamilton/BurlingtonYMCA of Brantford- My employer is not listed -Hidden This is a corporate donation HiddenCompany name (only include company name if you want the tax receipt to be made out to the company) Home Address(Required) Home Address * City * Province * AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Postal Code * Work Email(Required) Phone NumberPersonal Email Mobile NumberDedicate this donation I want my gift to make the most powerful impact possible and support the highest priority needs I wish to designate my gift Please write the name of the Registered Charity you wish to designate your gift towards.(Required)For more information please visit the Government of Canada WebsiteHiddenPrint your name as you would like it to appear in published materials Hidden Please do not publish my name American ExpressMasterCardVisaSupported Credit Cards: American Express, MasterCard, Visa Card Number Expiration Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name HiddenComments(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 Jesse VickeryDonate to Your Workplace Campaign06.17.2021
