Pledge Packet Contact Info Campaign Info Update Thank you for volunteering to build our support network and take out pledge packets for United Way's Campaign! Please complete this survey either digitally or with the paper that was given at pledge pick-up. Gathering this information is critical to not only our fundraising but creating connections as we grow our network and positively impact our community. Send any questions to Aunna at aunna@brookingsunitedway.org. Our contacts need to be updated! Please enter the information on who the contact at the business was. This information will be used for recognition purposes and to send the video. Add as many businesses as needed. Contact Information Full Name * Company Name * Phone * Email * Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Other notes plus1 Add minus1 Remove Submit If you are human, leave this field blank. Δ
