Granville County United Way Donation Form

Choose one of the following options:

Credit Card
Direct Bill

Please provide the following credit card and billing information:

Name as it appears on your Credit Card
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Home Phone
E-mail

Please charge my:  Visa   MasterCard   American Express   Discover

Please charge my above card or send me a direct billing for a ONE TIME donation of:
    
OR Please charge my Credit Card for my YEARLY donation of:
    
OR Please start billing me monthly for the MONTHLY amount of:
    

Credit Card Information
Credit Card # (No dashes necessary)
Expiration Date (Month/Year 00/00)

I would like my donation to go to:

The Community Care Fund - Thank you for supporting all our programs!      

Children and Youth Programs: Select which One 
Boy Scouts
Community Schools The Learning Lab

Girl Scouts
Granville County 4-H
Change For Youth
OYSA


Counseling Programs: Select which One   
Center for Living
Friends of Youth
Legal Aid of NC
 
        
Health Services: Select which One   
Addiction Recovery Center for Men

Addiction Recovery Center for Women

Harold Sherman Adult Day Care

Live Well Granville

           
Elderly Services: Select which One   
Northern Granville Nutrition Program

Senior Services Hotline
Senior Shuttle

             
Crisis Needs: Select which One   
American Red Cross
Area Congregations In Ministry (ACIM)

Lifeline Outreach
Families Living Violence Free

                

THANK YOU FOR DONATING TO THE GRANVILLE COUNTY UNITED WAY
You will receive a tax deduction receipt in the mail for your pledge amount!