Workplace Giving

Change starts with you. Take action today to make a difference in your community.

 

Employer Details

HR Contact Name *
 
HR Email Address *
 
Workplace
 
Company Name *
 
City *
 
Contact Number *
 
 

Personal Details

First Name *
 
Middle Name
 
Last Name
 
Email Address *
 
Mobile Number *
 
Declaration
I wish to participate with United Way NZ through Payroll Giving and therefore authorise the following to be deducted from my salary/wages.
 
 

I wish to donate to United Way

Donation Amount *
(Please Tick)
 
Donation Use *
 
If other please state
 
 
 
Confirmation Code
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Confirmation Code
 
Enter Code *
 
 
 
 
 
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