United Way Donation Form
United Way brings people and resources together to create positive change and lasting impact in our community.
United Way will never release or sell donor information.
*indicates a required field
My Personal Information
Preferred Email (for e-newsletters):
I have donated to UW for:
My United Way Pledge
Payroll deductions will be based on 26 pay periods.
Amount of payroll deduction (per pay period)*:
If Other, please type in the amount here (per pay period):
Total Pledged Amount*:
Please choose the market you want your donation to benefit.:
Yes, I am a Pillar! (Gift of $500 or more)
Name of Spouse/Significant Other:
List my/our name in the Pillar Book as follows:
Do you want my/our name published?:
My Community Investment
Please choose where you would like your donation invested.
COMMUNITY IMPACT FUND:
The most powerful way to impact lives in your county:
Focus my Community Impact Fund gift to one or more Community Goals
Health & Well-Being:
Specific Charitable Organization
Name of the charitable organization:
Do you want your name released to the designated agency in connection with this gift?:
I authorize First Busey Corporation to deduct the above amount via payroll deduction.
Within 1-2 business days, you will receive an email confirmation of your donation.