Valley Health Pledge Card | United Way of Northern Shenandoah Valley

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Valley Health System 2024 Campaign

Choose the entity you are assigned to:

Please designate which United Way you wish to support.

Contact Info

Name

Employer

Work Email

Home/Cell Phone

Home/Work Address

Address 2

City

State

ZIP Code

Employee ID Number

Personal Email

Preferred Donation Method

Payroll Deduction

Check

Direct Bill

Credit Card

Payroll Deduction

Contribution Amount Per Pay Period

$10

$20

$25

$50

Other…

Contribution Amount Per Pay Period

One Time

Bi-Weekly (26 pay periods)

TOTAL: $0

Check Donation

Amount of Check Donation $

Cash Donations

Amount of Cash Donation $

Direct Bill

Contribution Amount

Please Bill Me

Once

Quarterly

Designations

Choose how you want your donation invested:

Support Local Needs

Restricted gift

All Area Needs (Education, Financial Stability and Health)

Education Amount

Financial Stability Amount

Health Amount

Select to support an existing partner from within a particular United Way region

	Select an existing United Way of Northern Shenandoah Valley partner
	AbbaCare, Inc.
	Big Brothers/Big Sisters of Harrisonburg & Rockingham
	Blue Ridge Habitat for Humanity
	Blue Ridge Housing Network
	Blue Ridge Hospice
	Blue Ridge Legal Services
	Blue Ridge Opportunities
	Brain Injury Connections
	Child Safe Center CAC
	Cars Changing Lives
	Choices of Page County, Inc.
	Community Care & Learning Center
	Concern Hotline, Inc.
	Congressional Community Action Project (CCAP)
	DementiaMatters
	Dental Clinic of NSV
	Faithworks
	Family Promise of Shenandoah County
	Fremont Street Nursery
	Healthy Families Northern Shenandoah Valley
	Healthy Families Warren County
	Healthy Families Shenandoah and Page
	Highland Food Pantry, Inc.
	Horizon Goodwill Industries
	The Laurel Center
	LFCC Education Foundation
	House of Hope
	Literacy Volunteers Winchester Area
	Museum of the Shenandoah Valley
	Loaves and Fishes Food Pantry
	Northern Shenandoah Valley Substance Abuse Coalition
	Response, Inc.
	Shenandoah Alliance for Shelter
	Phoenix Project
	Shenandoah Community Health Clinic
	Shenandoah Dental Clinic
	Shenandoah Valley Discovery Museum
	Sinclair Health Clinic
	Staunton-Augusta Family YMCA
	Wheels for Wellness
	St. Luke Community Clinic
	Winchester Area Temp Thermal Shelter (WATTS)
	Winchester Day Preschool

Learn more about these agencies:

	Select an existing partner from County United Way
	Allegany County Human Resource Development Commission (HRDC)
	Associated Charities
	American Red Cross
	Horizon Goodwill
	The Family Junction
	Cumberland Housing Group
	Make-a-Wish of the Mid-Atlantic
	YMCA
	Tri-Towns After School Program
	Pressley Ridge
	Garrett County Community Action Agency
	Piedmont Library
	Catholic Charities WV
	AHEC West
	CASA of Allegany County
	Union Rescue Mission
	Local Management Board (Allegany County)
	Salvation Army
	Allegany County Youth Enrichment Program Services
	Family Crisis Resource Center
	Mineral County Family Resource Network
	Garrett Mentors
	Region 8 Planning and Development Commission
	Slanesville Elementary
	Western MD Food Bank
	Eastern Regional Family Resource Network
	Boy Scouts
	Developmental Center and Workshop
	Garrett County Habitat for Humanity

Learn more about these charities:

	Select an existing partner from United Way of Eastern Panhandle
	American Red Cross
	Berkeley County BackPack Program
	Berkeley County Meals on Wheels, Inc.
	Berkeley County Schools
	Berkeley Senior Services
	BlackCat Music Cooperative
	Boys and Girls Club of the Eastern Panhandle
	CASA of the Eastern Panhandle, Inc.
	Catholic Charities West Virginia
	CCAP/Loaves & Fishes
	Children First Child Development Center
	Children's Home Society of West Virginia
	Community Alternatives to Violence, Inc.
	Community Networks, Inc.
	Eastern Area Health Education Center (EAHEC)
	Eastern Panhandle Deaf Alliances, Inc.
	Eastern Panhandle Empowerment Center (EPEC)
	EP Instructional Cooperative
	EVAK K9 Search and Rescue
	Faith Community Coalition for the Homeless
	Faith Feeding Freedom
	Girls on the Run of the Shenandoah Valley
	Good Shepherd Interfaith Volunteer Caregivers
	Horses with Hearts, Inc.
	Junior Mentoring Programs
	Morgan County Homeless Coalition
	Morgan County Partnership
	Norborne Preschool & Day Care Center, Inc.
	Panhandle Home Health, Inc.
	PurposeFull Paws
	Shepherdstown Day Care
	Shenandoah Valley Medical System, Inc./ Morgan County Starting Points
	Stars That Shine
	Telamon Corporation
	University Healthcare Foundation

Learn more about these agencies:

Making multiple designations? Please specify any important details and amounts for each agency to receive here:

I'd like to give somewhere else:

Looking to give somewhere else? Feel free to type in another 501C3 agency or nonprofit name & address

Credit Card Donation

Amount of Credit Card Donation $

To complete your credit card or ACH donation, visit unitedwaynsv.org/donate after hitting submit below.

(Donation link is also provided on the confirmation page.)

Agreement

I agree to the terms of service

My signature below, confirms my payroll deduction request as stated above. I approve this pledge to Valley Health System’s 2022 United Way Pacesetters Campaign. I understand if I have selected payroll deduction(s) as my form of payment, the deductions will begin in January 2023.

I have reviewed my designations and confirmed that they add up to my total donation amount.

Signature