United Way of Long Island - Merchants Workplace Campaign

I want to contribute this amount every month every

Workplace Campaign 2024

Title

First Name *

Last Name *

Company/Union *

Street Address *

City *

State *

Zip Code *

Email Address *

Is the above a work email address? *

Yes No

Phone *

Is the above a work phone number? *

Yes No

Donor Designation

Long Island Impact Fund - Helping families afford basic needs & gain access to resources

Mission United for Veterans

YouthBuild for At-Risk Youth

Project Warmth: LI's Emergency Fuel Fund

Community Partner Agency

Name of Community Partner Agency

Please type the name of your designated 501(c)(3) community partner agency here. For a list of United Way of Long Island’s community partner agencies visit www.unitedwayli.org/communitypartners.

United Way of Long Island's most recent financial reports are accessible at www.unitedwayli.org/aboutus/financial-information. And, the New York State Office of the Attorney General may be contacted at 212.416.8401, or by visiting www.charitiesnys.com, if necessary.

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