Donate
1. PLEASE COMPLETE THE UPPER PORTION OF YOUR PLEDGE FORM IF IT HAS NOT
ALREADY BEEN COMPLETED FOR YOU.
2. For Payroll Giving: Write in the amount to be deducted each pay period as well as your TOTAL annual gift. Your total gift and designations should be equally divisible by 12 or 26 (depending upon your payroll periods). You must include your Social Security Number (US Postal Service employees ONLY may use your eight-digit Employee ID) if you are giving through payroll deduction. (Note: If your service/employment period will end on or before 12/31/11, please donate by cash or check.)
3. For Cash or Check Giving: Write in the amount of your total gift. Make checks payable to the Combined
Federal Campaign — NOT TO YOUR DESIGNATED CHARITY.
4. Designate the Charity(ies) of Your Choice: Write the FIVE-digit charity code(s) in the blocks provided.
PLEASE double check to be certain the code(s) are correct and are only those listed in the CHARITY
LISTING. You can designate up to five agencies per pledge form. Use additional forms if you are designating
to more than five charities. Indicate the amount you wish to designate to the charity(ies) in the box next to the
charity code number.
5. Release of Information: Indicate whether or not you wish to have your contact information and/or the amount
of your gift released to the charity(ies) you designate as the recipient(s) of your contribution.
6. Date and Sign Your Pledge Form: Make certain you date and sign your pledge form to validate your payroll
deduction contribution. Your Social Security Number (or Employee ID for USPS employees) must be provided
if you are giving through payroll deduction. (Note: Your Social Security Number and/or USPS ID will appear
ONLY on the payroll office copy of your pledge form.)
7. Detach the last/pink copy (#3 – Contributor copy) from the pledge form pack. Keep this copy for your
records.
8. Give the first/white copy (#1 - Payroll Office Copy) and the second/yellow copy (#2 - Central Receipt
Copy) to your Coordinator/Keyworker or to the CFC Director or Campaign Assistant.
Pledge Card
2011 Greater Hartford Charity Listing.pdf
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