Small Business United E-Pledge Form

Name/Nombre*
First Middle Last
Company Name*
Mailing Address*
Phone Number*
Email*
Small Business United Donation Amount*
Check one of the following:*
- MASTERCARD
- VISA
- AMERICAN EXPRESS
- DISCOVER
- PERSONAL CHECK
Please attach check and make payable to United Way of South Texas. - 113 W. Pecan Blvd., McAllen, TX 78501
Credit Card Information*
Card Number Expiration Date (MM-YY) CSV Code Cardholder Name
I authorize my Small Business United Donation as listed above.*
- Agree
Signature (Print Full Name in Box Below)*
Date*
Month
Day
Year
Signature*
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