Make a secure on-line donation or pledge now with your Visa or Mastercard
OR
Print this form and mail it with your check or credit/debit card information to:
United Way of Hampshire County
PO Box 123
Northampton, MA 01061-0123
Make checks payable to United Way of Hampshire County
Thank you for inspiring hope and creating opportunities in our local community through your giving.
![]()
______________________________________________________________
Name(s)
______________________________________________________________
Name(s) cont'd
______________________________________________________________
Address
______________________________________________________________
Street
______________________________________________________________
City/State/Zip
______________________________________________________________
Telephone
______________________________________________________________
E-mail
![]()
Donation Amount Total $______________
___ I/we wish to make the full donation amount today.
or
___ Divide my/our donation pledge in 4 or 12 equal installments of $________
Debit/Credit (circle one if applies) MasterCard or Visa
______________________________________________________________
Cardholder Name
______________________________________________________________
Card Number
______________________________________________________________
Expiration Date
______________________________________________________________
CVN Number
Comments/Other instructions:
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
______________________________________________________________
Please notify us if you plan to make a gift by stock transfer. Call the United Way of Hampshire County 413-584-3962 for assistance. Direct transfers can be made to the UWHC Account: Merrill Lynch #57E-04009 DTC #5198.
The United Way of Hampshire County is a 501(c)(3) organization. Donations are tax deductible to the full extent of the law

