Pledge Card

Your Name
Your Contact Information
Donation Method
Payroll Deduction
$
Check Donation
$
Make checks payable to United Way of Ponca City. Please give the check to your Campaign Coordinator within 24 hours of this pledge.
Cash Donation
$
Please give your cash donation to your Campaign Coordinator within 24 hours of this pledge.
Bill Me Details
$
Credit Card Donation
$
After completing this form you will be redirected to our payment page where you will be able to process your transaction in a secured environment. Please be sure to enter the same values that you have entered on this form. Thank you!
Total Annual Contribution
$0
Donation Details
Agreement
My signature below, confirms my pledge as stated above.

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