I would like to support United Way of Etowah County's efforts to improve the lives of people in Etowah County.

Please find my enclosed check in the amount of $______________________ or

Bill me ______ once: ______ monthly: ______ quarterly on (Date) ______ or

Payment by Credit Card:

                               
__ American Express     __ Discover     __ Visa     __ Mastercard      EXP.____________


Signature Required: _______________________________________________________________
Name:
Street Address:
 
 
State:
ZIP:
Country:
Telephone:
E-mail Address: