2023 LA SCCC - Charity List & Pledge Form

Louisiana Association of United Ways

Webster Claiborne Union Morehouse Ouachita Richland Madison East Carroll West Carroll Lincoln Bienville Jackson Winn DeSoto Red River Natchitoches Sabine Vernon Grant LaSalle Rapides Catahoula Avoyelles Concordia Caldwell Franklin Tensas EvangelineSt. Landry Beauregard Allen Calcasieu Cameron Jefferson Davis Acadia Vermilion Lafayette St. Martin Iberia St. Martin St. Mary Terrebonne Assumption Lafourche West Feliciana East Feliciana East Baton Rouge St. John the Baptis Pointe Coupee Iberville St. James St. Helena Livingston Ascension Tangipahoa Washington St. Tammany Charles Orleans Jefferso n Plaquemines

9

7

2 Region 3

4 Region 5 Region 8 West Baton Rouge Region 6 Region 1

Region

of supporting our Louisiana!

years

FAQs

Regions served:

Louisiana Association of United Ways

TOTAL of Designations (should match TOTAL DONATION made in Step 2) =

10 ( )

Louisiana Association of United Ways Required Required Required 4-Digit Code: Charity Name: Total ANNUAL Designation for each Charity: $ $ $ $

$

SIGNATURE (By my signature, I authorize this contribution.) Date

REQUIRED

Louisiana Association of United Ways

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