Donations – Texas Regional Bank E-Pledge Card

Description of United Way Service Areas:

United Way of South Texas (956-686-6331):
Serving Hidalgo and Starr Counties, including all communities between Mercedes, TX and Roma, TX

United Way of Northern Cameron County (956-423-5954):
Serving Combes, Harlingen, La Feria, San Benito, Santa Maria, Santa Rosa, Rio Hondo, and Willacy County

United Way of Southern Cameron County (956-548-6880):
Serving Brownsville, Los Fresnos, Olmito, Rancho Viejo, Laguna Vista, Laguna Heights, Port Isabel, and South Padre Island

The form below will be processed for payroll deduction, should you wish to pledge via credit card or check, please contact your local United Way directly.

CIty of Donna E-Pledge Form

Name/Nombre*
First Middle Last
Department/Departamento*
Last four of your SS#/Últimos 4 números del Seguro Social*
Complete Employee ID #/Número Completo de Empleado*
Donation Amount Per Pay Period/Cantidad de Donacion por Periodo de Pago*
Pay Period Frequency/Frecuencia de Periodo de Pago*
- Bi-Weekly/Cada Quincena
Email/Correo Electrónico*
Address/Residencia
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
I authorize my Payroll Department to process the pledge information entered above for payroll deduction. Autorizo a mi Departamento de Nómina a procesar la información de compromiso ingresada anteriormente para la deducción de la nómina.*
- Agree
Signature (Print Full Name in Box Below)*
Date*
Signature*

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Donations – Texas Regional Bank E-Pledge Card

Description of United Way Service Areas:

The form below will be processed for payroll deduction, should you wish to pledge via credit card or check, please contact your local United Way directly.

CIty of Donna E-Pledge Form

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