Please do not mail this envelope. Call (860) 493-6800 for pick-up. For Campaign Use Only:
Company ID #
Envelope #
Initials
UNITED WAY CAMPAIGN SPECIAL EVENT REPORT ENVELOPE CAMPAIGN YEAR: Organization Name Street Address City
State
Zip
STEP 1: SPECIAL EVENT INFORMATION NAME OF EVENT
TOTAL AMOUNT
AMOUNT ENCLOSED
GRAND TOTAL FOR ENVELOPE * Please use Report Envelope for funds not related to special events.*
STEP 2: CAMPAIGN COORDINATOR INFORMATION Name Date
Signature Phone
STEP 3: BILLING INFORMATION, IF APPLICABLE Billing Address
Phone
Contact for Company Billing Questions
(Campaign Use Only)
Donor Relations: Staff/LE Name: __________________________________________ Date: __________________________________________________ United eWay Campaign Use Only: Uploaded By/Date________________________________________
Donor Services: Credit Date: _________ Deposit Date: _________ Deposit ID#: _________ Audited By: _______________________________ Date: _______________ Processed By: _____________________________ Date: _______________ Date Posted: ___________________________________________________ Batch Control Number
THANK YOU! United Way Campaign • 30 Laurel Street • Hartford, CT 06106-1374 • (860) 493-6800 • FAX (860) 493-6859 • unitedwayinc.org
ATTENTION: Company Coordinator Please complete the face of the envelope, seal it, and sign across the flap.
Thank you for your dedication to improve lives for children and families our community!
0514-1000